2016 Physician Quality Reporting System (PQRS) Feedback Reports and 2016 Annual Quality and Resource Use Reports (QRURs) are available now. The reports 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.
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 as well as information on how to file an informal review. If you perceive 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 December 1, 2017 8:00 pm Eastern Time. More information on how to file and informal review can be found below.
Your 2016 PQRS Feedback Report contains detailed information needed to determine your program year 2016 PQRS reporting results and indicates if you are subject to the 2018 PQRS downward payment adjustment. The 2016 Annual QRURs show how groups and solo practitioners performed on quality and cost measures relative to national benchmarks and indicate if physicians, PAs, NPs, CNSs, and CRNAs will receive an upward, neutral or downward Value Modifier adjustment to their payments for items and services rendered under the Medicare Physician Fee Schedule in 2018.
The PQRS and Value Modifier programs end in 2018. The Merit-based Incentive Payment System (MIPS) under the new Quality Payment Program is replacing them. The first performance period of the Quality Payment Program is January 1, 2017 through December 31, 2017, and the first payment adjustment year will be 2019.
The Quality Payment Program replaces the Physician Quality Reporting System (PQRS), the Value Modifier Program, and the Medicare Electronic Health Record Incentive Program, reduces quality reporting burden, and has many flexibilities that allow eligible clinicians to pick their pace for participating in the first year.
Clinicians will be able to practice as they always have, but they may receive higher Medicare payments based on their performance for participating in the Quality Payment Program. CMS is committed and diligently working with clinicians to support their successful transition into the Quality Payment Program. CMS’ goal is to further reduce burdensome requirements and empower patients and clinicians to make decisions about their healthcare.
To prepare for success in the Quality Payment Program, clinicians and their practice professionals are encouraged to review their PQRS feedback report, annual QRUR, and visit https://qpp.cms.gov to learn about the Quality Payment Program.
How to Access the Reports:
- Enterprise Identity Management (EIDM) Account. An EIDM account with the appropriate role is required for participants to obtain 2016 PQRS Feedback Reports and 2016 Annual QRURs.
- If you already have an EIDM account, then follow the instructions provided here to sign up for the appropriate role in EIDM.
- To find out if there is already someone who can access your PQRS Feedback Report and QRUR, contact the QualityNet Help Desk.
- To sign up for an EIDM account, visit the CMS Enterprise Portal and click “New User Registration” under “Login to CMS Secure Portal.” Instructions for signing up for an EIDM account are provided here.
- Both reports can be accessed on the CMS Enterprise Portal using the same EIDM account.
- See the “Quick Reference Guide for Accessing 2016 PQRS Feedback Reports” or the “Quick Access Guide for 2016 PQRS Feedback Reports” for additional information. Both are available on the PQRS Analysis and Payment webpage.
- Visit the How to Obtain a QRUR webpage for instructions on accessing a 2016 Annual QRUR.
How to File an Informal Review:
- If you believe you were assessed the 2018 PQRS downward payment adjustment in error, please submit an informal review request.
- For more information about the informal review process, view the “2016 Physician Quality Reporting System (PQRS): 2018 Downward Payment Adjustment - Informal Review Made Simple” guide on the PQRS Analysis and Payment webpage.
- For the 2018 Value Modifier, groups and solo practitioners may request an informal review of perceived errors in their 2018 Value Modifier calculation. Additional information about how to request an informal review is available on the 2016 QRUR and 2018 Value Modifier webpage.
- You may request an informal review of your 2016 PQRS results and/or 2018 Value Modifier calculation during the informal review period that will begin on September 18, 2017 and close on December 1, 2017 8:00 pm Eastern Time.
Help Desk Information:
- For additional assistance regarding EIDM or the content or data contained in the PQRS Feedback Reports, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715- 6222) from 7:00 a.m. to 7:00 p.m. Central Time, Monday through Friday, or via email at firstname.lastname@example.org. To avoid security violations, please do not include personal identifying information such as Social Security Number or Tax Identification Number in email inquiries to the QualityNet Help Desk.
- For additional assistance regarding the QRUR or the Value Modifier, or if you are having trouble accessing the PQRS Feedback Reports, contact the Physician Value Help Desk at email@example.com or 888-734-6433 (select option 3)
Additional Information on PQRS Feedback Reports or QRURs: