The Affordable Care Act also required CMS to provide an option for a physician to report data on quality measures through a Maintenance of Certification (MOC) Program operated by a specialty body of the American Board of Medical Specialties. An incentive payment of 0.5 percent, additional to the PQRS bonus, is authorized for years 2011-2014 if certain requirements are met, including:

  • Must first have successfully participated in PQRS for a 12-month period; i.e., January 1 – Dec 31 (not the six-month reporting option), and
  • More frequently than is required to qualify for or maintain board certification:
    • Participate in a MOC program, and
    • Successfully complete a qualified MOC program practice assessment, which must include a survey of patient experience with care as part of the practice assessment.

The additional 0.5 percent is authorized through 2014. Beyond 2014, participation in the PQRS MOC Program option may be incorporated into a "composite of measures" of quality furnished under the physician fee schedule value-based payment modifier.

Changes to the Maintenance of Certification (MOC) Program PQRS Incentive for 2012

CMS "simplified" the requirements for participation in the MOC Program Incentive by making the "more frequently" requirement apply to any one component instead of all four components of an MOC Program (excluding Part 1, Maintenance of Licensure). CMS also indicates that with respect to the practice assessment (Part IV) that at least one practice assessment activity should be completed every year the eligible professional wishes to receive the incentive.

Background Information
The PQRS Maintenance of Certification (MOC) Program Incentive began in January 2011. Under the program, physicians who are incentive eligible for the Physician Quality Reporting System, or "Physician Quality Reporting" can receive an additional 0.5% incentive payment when Maintenance of Certification Program Incentive requirements have also been met.

A "qualified Maintenance of Certification program practice assessment," as defined in the ACA, is one that includes an initial assessment that demonstrates the physician's use of evidence-based medicine; a survey of patient experience with care; and implementation of a quality improvement intervention to address a practice weakness identified in the initial assessment. The practice assessment must also require the practice to reassess performance improvement after the intervention.

Maintenance of Certification Program entities, such as the American Board of Radiology (ABR), may self-nominate to CMS for qualification as a MOC program for submitting participation data on a physician's behalf. CMS identified the ABR as a "fully qualified Maintenance of Certification Program Incentive Entity" for 2011 and expects continued qualification for 2012. Radiologists who would like to be considered for the 2012 Maintenance of Certification Program Incentive will need to work with the ABR to ensure successful completion of the MOC Program Incentive participation requirements.