5-21-07
OTs Eligible for Bonus Under Quality Reporting Initiative
A major American Occupational Therapy Association (AOTA) advocacy effort paid off with the inclusion of occupational therapists in the Medicare Physician Quality Reporting Initiative (PQRI) program. AOTA has been informed that occupational therapists will be eligible to participate in the PQRI by using the quality measure "screening for future fall risk."
The Tax Relief and Health Care Act of 2006 established the PQRI program, which provides a bonus payment to Medicare Part B providers for reporting quality measures for the second half of 2007, for the period from July 1 to December 31. There also will be a PQRI program in 2008, but it will likely use different or additional quality measures. The bonus will be a 1.5% lump sum payment, subject to a cap, of total allowed charges for covered Medicare physician fee schedule services.
For the 2007 PQRI, the Centers for Medicare & Medicaid Services (CMS) is using 74 quality measures from the 2007 Physician Voluntary Reporting Program. AOTA has analyzed the 74 quality measures and submitted a proposal for occupational therapists to participate in the "screening for future fall risk" measure because it clearly falls within the occupational therapy scope of practice and because of occupational therapists' expertise in fall prevention.
AOTA advocated with CMS and with the American Medical Association's Physician Consortium for Performance Improvement and the National Committee for Quality Assurance to assure occupational therapy's participation.
The 2007 PQRI program will be in place from July 1 to December 31. Participating therapists will be required to include their National Provider Identifier (NPI).
CMS will be issuing detailed instructions on how to participate in the program in the near future. Occupational therapists are encouraged to check the AOTA Web site frequently for updates. Another source of information is CMS's PQRI Web site.
