Time is Running Out: Request an Informal Review of Your QRUR or PQRS Report by November 30

CMS recently released the 2015 Annual Quality and Resource Use Reports (QRURs). The 2015 Annual QRURs show how physician groups and physician solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier, as well as their 2017 Value Modifier payment adjustment.

Physicians should carefully review their QRURs, and may request an informal review if they think there are errors in their 2017 Value Modifier calculation. The informal review period is open now through November 30, 2016, at 11:59 p.m. ET. Information about how to access your 2015 Annual QRURs and how to request an informal review is available on the 2015 QRUR and 2017 Value Modifier web page.

In addition, the 2015 Physician Quality Reporting System (PQRS) reports are available. These reports use data from PY 2015 PQRS to determine if the 2017 PQRS negative payment adjustment will be applied. Individual EPs and PQRS group practices who satisfactorily reported data on quality measures for covered Medicare PFS services furnished to Medicare Part B FFS beneficiaries will avoid the 2017 PQRS payment adjustment.

Individual EPs and group practices that think they have been incorrectly assessed the 2017 PQRS negative payment adjustment may request to have an informal review of their PQRS reporting performance. Informal review requests for 2015 reporting may be submitted through November 30, 2016, at 11:59 p.m. ET. To request an informal review, visit the Physician and Other Health Care Professionals Quality Reporting Portal, then select “Communication Support Page” under “Related Links” in the upper left navigation pane. In the drop down menu, select “Informal Review Request” and choose the appropriate option. See the 2015 PQRS: 2017 PQRS Negative Payment Adjustment - Informal Review Made Simple.

Note: Any physician or group that is awaiting a response or resolution of a QualityNet Help Desk ticket to access their PQRS Feedback Report or QRUR may still submit an informal review after November 30, 2016, by providing verification of a QualityNet Help Desk ticket number generated before the end of the informal review period (November 30, 2016) that involves EIDM access. Individuals or groups (as identified by their Taxpayer Identification Number) may also use EIDM-related help desk tickets generated during the informal review period to enable late filing of a Value Modifier or PQRS informal review request. These late requests may be submitted through December 7, 2016.

If you need additional assistance, please contact Allison Madson, manager of regulatory affairs at amadson@ascrs.org or 703-591-2220.