Time is Running Out for Informal Review of 2016 Value Modifier

If you are in a practice with 10 or more eligible providers subject to the 2016 Value Modifier, which will apply to the Medicare Physician Fee Schedule for 2016, you may want to request an informal review of your value modifier determination before Nov. 9.  If you think there is an error in the calculation, this is your opportunity to request a correction.

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.

Groups and solo practitioners are identified in the QRURs by their Taxpayer Identification Number (TIN).  The QRURs are also  available for groups and solo practitioners that participated in the Medicare Shared Savings Program, the Pioneer Accountable Care Organization (ACO) Model, or the Comprehensive Primary Care initiative in 2014, and to those TINs consisting only of non-physician eligible professional (EPs).

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).

Also, next Wednesday, Oct. 28, from 2 – 3 p.m., The Centers for Medicare & Medicaid Services (CMS) will hold the second session of a three-part Virtual Office Hours series titled “2015 PQRS Reporting Measures Series (Session 2 of 3): Measures Overview.” Topics to be discussed in this session include an overview of the measures, and live walkthroughs of the 2015 PQRS Measures List and the 2015 PQRS Individual Claims/Registry Measure Specification Supporting Documents.

This PQRS Virtual Office Hours session will allow stakeholders an opportunity to ask a CMS representative questions about how to get started with quality measures for 2015 PQRS reporting. To participate in this session, please register here.

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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