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15 Days Left to Submit an Informal Review Request - Review Your 2016 PQRS Feedback Report and 2016 Annual Quality and Resource Use Report Now

Nov 16, 2017

2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs) were released on September 18, 2017. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. The 2016 Annual QRURs show how physicians, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier as well as their practice’s 2018 Value Modifier payment adjustment. The payment adjustments shown in the reports are based on proposals that were included in the 2018 Medicare Physician Fee Schedule Proposed Rule (https://federalregister.gov/d/2017-14639). If the policies are not finalized as proposed, CMS will provide an update to report recipients.

Access and review your 2016 PQRS feedback report and 2016 Annual QRUR now to determine whether you are subject to the 2018 PQRS downward payment adjustment and your practice’s 2018 Value Modifier payment adjustment.

If you believe your payment adjustment status was made in error, you may request an informal review of your 2016 PQRS results and/or 2018 Value Modifier calculation during the informal review period from now until 8:00 pm Eastern Time (ET) on December 1, 2017. 

An Enterprise Identify Management (EIDM) account with the appropriate role is required for participants to obtain their 2016 PQRS Feedback Reports and 2016 Annual QRURs. Both reports can be accessed on the CMS Enterprise Portal using the same EIDM account. Visit the How to Obtain a QRUR webpage for instructions on accessing both reports.

To find out which reports are available for your practice and your current and past PQRS and Value Modifier payment adjustments, you can use the new Payment Adjustments and Reports Lookup feature on the CMS Enterprise Portal. An EIDM account is not needed to use this feature. Instructions for using this feature are located in the “Guide for Accessing the Payment Adjustment and Reports Lookup Feature”.

For more information on your PQRS feedback report:

For more information on your Annual QRUR:

For the 2016 reporting period, the majority of eligible professionals (EPs) successfully reported to PQRS and avoided the downward payment adjustment. CMS anticipates that successful trend to continue under the new Quality Payment Program. The Quality Payment Program began January 2017 and replaces PQRS, the Value Modifier program, as well as the separate payment adjustments under the Medicare Electronic Health Record (EHR) Incentive Program for EPs. The Quality Payment Program streamlines these legacy programs, reduces quality reporting requirements and offers many flexibilities that allow eligible clinicians to pick their pace for participating in the first year. To prepare for success in the Quality Payment Program, we encourage EPs to review their PQRS feedback report, Annual QRUR, and visit qpp.cms.gov to learn about the Quality Payment Program.

Questions:

  • For assistance with Enterprise Identity Management or PQRS feedback reports, contact the QualityNet Help Desk at 866-288-8912 (TTY 877-715- 6222) or qnetsupport@hcqis.org.
  • For assistance with the QRURs or Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).
Both Help Desks are available Monday through Friday from 7:00 a.m. to 7:00 p.m., Central Time.