CMS Extends Deadline for Physician Quality Reporting System (PQRS) Informal Review Process

The Centers for Medicare and Medicaid Services (CMS) is extending the 2014 Informal Review period until Nov. 23, 2015 for those individuals and practices requesting a review of their value modifier determination. This determination will apply to the Medicare Physician Fee Schedule for 2016. If you think there is an error in the calculation, you now can request a review until Monday, Nov. 23, an extension from the previous deadline of Nov. 9, 2015.

All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP).  Please see 2014 Physician Quality Reporting System (PQRS): Incentive Eligibility & 2016 Negative Payment Adjustment – Informal Review Made Simple for more information.

The value modifier is based on the 2014 Annual Quality and Resource Use Reports (QRURs), which are now available for every group practice and solo practitioner nationwide. These reports show how groups and solo practitioners performed in 2014 on the quality and cost measures used to calculate the 2016 Value Modifier. For practices with fewer than 10 eligible providers and solo practitioners, the QRUR is for informational purposes only and will not affect their payments under the Medicare Physician Fee Schedule in 2016.

Authorized representatives of group and solo practitioners can access the 2014 Annual QRURs on the CMS Enterprise Portal using an Enterprise Identify Data Management (EIDM) account with the correct role.  For more information on how to access the 2014 Annual QRURs, visit How to Obtain a QRUR.

Additional information about the 2014 QRURs and how to request an informal review is available on the 2014 QRUR website and through the QRUR Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).

For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number (TIN), in e-mail inquiries to the QualityNet Help Desk.

Don’t forget to keep up with important deadlines and information like this on our Quality Time with the NCMS webpage. Simply log on and have access to valuable resources to ensure you are fully informed.

 
 

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