A downward payment adjustment in 2017 will be applied by CMS to those who didn’t satisfactorily report PQRS in 2015 involving:
Please don’t hesitate to submit an informal review request, if you’ve any queries in context to the status of your 2015 PQRS reporting or are concerned over potentially getting the PQRS downward payment adjustment in 2017. Every individual EP or PQRS group practice will be in contact and in-touch with the CMS that submits an informal review request of their 2015 PQRS data.
Please submit an informal review between September 26, 2016 and November 30, 2016 requesting CMS investigate your payment adjustment determination, if you consider you’ve been wrongly or incorrectly assessed the 2017 PQRS payment adjustment. Entire informal review requestors will be notified through email of a final decision by CMS within ninety days of the original and genuine request for an informal review. There will be no further review and all decisions will be final.
To submit an informal review request, follow these steps:
For more information, please visit the PQRS informal review fact sheet.
Point To Remember: Any EP or group that is awaiting a response or resolution of a QualityNet Help Desk ticket to access their PQRS Feedback Report or QRUR might still submit an informal review after the day of November 30, 2016, by giving verification of a QualityNet Help Desk ticket numbers generated before the end of the informal review period (November 30, 2016) that include EIDM access. Individuals or groups as identified by their TIN (taxpayer Identification Number) might also use EIDM-related help desk tickets generated during the informal review time period to enable late filing of a Value Modifier or PQRS informal review request. Through December 7, 2016, these late request might be submitted.
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