The Centers for Medicare & Medicaid Services (CMS) recently released the 2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs). If you think your payment adjustment status was made in error, you may request an informal review. Physicians have from now until 8:00 p.m. ET on December 1, 2017, to submit an informal review. Below are two reference guides to assist you in the informal review process.
- 2016 PQRS: 2018 Downward Payment Adjustment – Informal Review Made Simple Guide
- 2018 Value Modifier Informal Review Request Quick Reference Guide
As a reminder, the PQRS Feedback Reports reflect the existing PQRS requirements under current law except for the adjustment summary section. The adjustment summary section has been revised to reflect the CY 2018 MPFS proposed rule, which proposes to reduce the required number of reporting measures submitted for 2016 PQRS from nine to six.
The QRURs are based on the proposals in the 2018 MPFS proposed rule. CMS proposes to hold physicians harmless from downward payment adjustments from 2016 VBPM quality tiering if they satisfy the requirements for PQRS. If the policies are not finalized as proposed, CMS will provide updated reports to recipients. The final rule is expected to be released in early November.
To access your reports:
- An Enterprise Identity Management (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, 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 create an EIDM account, visit the CMS Enterprise Portal and click “New User Registration” under “Login to CMS Secure Portal.” Instructions for creating an EIDM account are provided here.
- Both reports may be accessed on the CMS Enterprise Portal using the same EIDM account.
If you have questions, please contact Allison Madson, manager of regulatory affairs, at firstname.lastname@example.org or 703-591-2220.