REMINDER: Reporting requirement for ACOs

If you are in an ACO,
you do not need to submit PQRS data.

There has been some confusion about reporting deadlines for Accountable Care Organization (ACO) participants, so here is a recap of key points:

  • The ACO will submit data for the TIN.
  • Not every physician in the ACO will be selected for reporting
  • If the ACO satisfactorily reports PQRS measures for the reporting period, its ACO participant TINs and the eligible professionals (EPs) billing through those TINs will avoid the PQRS downward payment adjustment. Please note: this applies to all EPs billing through the TIN, even those who were not selected for reporting.
  • If you were not selected for reporting, you are not eligible to report independently.

Q6: I bill through the TIN of an ACO participant. May I participate in PQRS under that TIN apart from the ACO to avoid the PQRS payment adjustment?

A6: No. Eligible professionals that bill through the TIN of an ACO participant on the ACO’s certified list of ACO participants can only meet PQRS reporting requirements when the ACO completely reports the GPRO Web Interface measures under the Medicare Shared Savings Program. You may not report for purposes of PQRS, under the ACO participant TIN, apart from the ACO.