clinical social work association

December 8, 2015

Dear CSWA Affiliated Society Members,

Here is some good news for LCSWs in dealing with PQRS in 2016.  There are no changes from the reporting necessary to be PQRS compliant from 2015!

There are still seven PQRS measures that apply to LCSWs and have QDCs that we report on the CMS-1500.  That means LCSWs still do not meet the Medicare requirement of nine measures and three domains.  Simply apply as many of the measures as you can to 50% of all Medicare patients and you will be compliant with PQRS through the MAV process.

Please review carefully the instructions on how to document PQRS measures which can be found at http://www.clinicalsocialworkassociation.org/Resources/Documents/CSWA%20-%202015%20PQRS%20Requirements%20for%20LCSWs%20%20%28FINAL2%29%20-%202-15.pdf to refresh your memory about how to submit QDCs.  The date will be changed from 2015vto 2016 shortly.

A 2015 summary chart (soon to be changed to 2016) is also available at http://www.clinicalsocialworkassociation.org/Resources/Documents/CSWA%20-%20PQRS%202015-A%20glossary%20and%20chart--4.12.15%20%281%29.pdf which has the seven measures and domains listed out.

Failure to comply with all the instructions listed the above documents may result in PQRS non-compliance in 2016 and a 3% reimbursement cut for Medicare payments in 2018. It appears that the vast majority of CSWA members who chose to become PQRS compliant were successful in doing so.  Most of the few members who were found to be non-compliant in 2015 understand what needs to be changed to avoid non-compliance in 2016.

Remember that you still can request an informal review if you have been told that you were non-compliant until December 16, 2015. Here are the links and phone numbers to use: Information about how to request an informal review is available 1) on the 2014 QRUR website; 2) through the QRUR Help Desk at pvhelpdesk@cms.hhs.gov ; or 3) at 888-734-6433 (select option 3).

If you chose not to be compliant until now in 2015, it is too late to become compliant, but you can start doing so in 2016.

I wish you all happy holidays. 

Laura Groshong, LICSW, CSWA Director, Policy and Practice

Clinical Social Work Association
The National Voice of Clinical Social Work
Strengthening IDENTITY | Preserving INTEGRITY | Advocating PARITY