Physicians have until December 1 to dispute 2016 PQRS and QRUR findings The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2018 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (Value Modifier) programs. Physicians who have concerns about the findings in their report(s) have until December 1, 2017, to file for an informal review of their data. The penalties stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully report on PQRS in 2016 will result in a 2 percent penalty in 2018. Value Modifier penalties can range from 1 to 4 percent, depending on the size of the practice and its performance on cost and quality measures. PQRS penalties will be communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS website. Value Modifier penalties can be found in the Quality and Resource Use Reports (QRUR), which are only posted on the website. Physicians may access both their 2016 PQRS feedback reports and QRURs on the CMS Enterprise Portal using an Enterprise Identity Management account. For details on how to obtain your QRUR report, see “How to obtain a QRUR” on the CMS.gov webpage. For information on obtaining your PQRS report, see the “Quick Reference Guide for Accessing 2016 PQRS Feedback Reports.” For information on understanding your report, see the “2016 PQRS Feedback Report User Guide.” Both of the PQRS guides are available on the PQRS Analysis and Payment webpage. For more information on understanding the reports, CMS is hosting a webcast on October 19 from 10:30 a.m. to 12 p.m. PT, which will provide a QRUR overview and explain how to interpret and use the report information. To register for this event click here, or contact mlnevents@blhtech.com for registration assistance. Physicians who wish to dispute their PQRS findings are urged to submit a request for informal review. While in most cases a successful PQRS review will trigger an automatic review of related Value Modifier penalties, program officials say the safest course is to file separate requests for review of both PQRS and Value Modifier data. All informal review requests must be submitted electronically through the Quality Reporting Communication Support Page by December 1, 2017, at 5 p.m., PT. Practices will be contacted by email with a final decision from CMS within 90 days of the original request for an informal review. All decisions will be final, with no opportunity for further review. Practices that do not receive a response are encouraged to check their junk or spam email folders for the decision, as it will be communicated via email only. CMS also has published the “2018 Value Modifier Informal Review Request Quick Reference Guide.” Physicians who have general questions about the report or have trouble accessing the reports online should contact the Physician Value Help Desk at (888) 734-6433 (select option 3) or pvhelpdesk@cms.hhs.gov. For additional questions, please contact the QualityNet Help Desk at (866) 288-8912 [TTY: (877) 715-6222] or via qnetsupport@hcqis.org between the hours of 5 a.m. and 5 p.m., PT, Monday through Friday. For information regarding other Medicare physician quality programs that apply payment adjustments, please see the Value-Based Payment Modifier website. October 13, 2017 Medicare Medicare, Physician Quality Reporting System, PQRS, Quality Reporting, Value-Based Payment Modifier 0 0 Comment Read More »
CMS National Provider Calls include discussions on PQRS and Physician Compare in September The Centers for Medicare and Medicaid Service’s (CMS) September 2017 National Provider Call topics include the Physician Quality Reporting System (PQRS) on September 26 and on Physician Compare on September 28. PQRS provider call: While 2016 was the last program year for PQRS and the final data submission time frame for reporting 2016 PQRS quality data to avoid the 2018 payment penalty was January through March 2017, this call will cover PQRS penalties, feedback reports, and the informal review process for 2016 results and 2018 payment adjustment determinations. For more information and to register, click here. Physician Compare provider call: This call is for individuals interested in learning more about Physician Compare, a database with demographic information, performance scores and participation information for clinicians and groups who took part in CMS quality programs. The call will cover the upcoming 30-day preview period for the 2016 performance data targeted for release in December, the future of public reporting and what is coming in the next year. For more information or to register, click here. September 27, 2017 Medi-Cal, Medicare CMS, Physician Compare, Physician Quality Reporting System, PQRS 0 0 Comment Read More »
Are you exempt from ICD-10 PQRS penalties in 2016? On October 1, 2016, new ICD-10 code sets went into effect that will impact the ability of the Centers for Medicare and Medicaid Services (CMS) to process data reported on certain quality measures for the fourth quarter of 2016. Because of this, CMS announced that it will waive 2017 or 2018 Physician Quality Reporting System (PQRS) payment adjustments, if applicable, for any physician or group practice that fails to satisfactorily report for 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the fourth quarter of 2016. Diabetes Cataracts Oncology Cardiovascular Prevention Diabetic Retinopathy The 2016 reporting deadline is February 28, 2017. Click here to read the CMS FAQ on the ICD-update and its impact on PQRS. February 13, 2017 General CMS, Centers for Medicare and Medicaid Services, ICD-10, Physician Quality Reporting System, PQRS 0 0 Comment Read More »
Deadline extended to dispute 2015 PQRS and QRUR findings The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. Today, CMS announced that physicians who have concerns about the findings in their report(s) have until December 7 to file for an informal review of their data. The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully complete required PQRS reporting in 2015 will result in a 2 percent penalty in 2017. VM penalties can range from 1 to 4 percent, depending on the size of the practice and its performance on cost and quality measures. PQRS penalties will be communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS website. VM penalties can be found in the Quality and Resource Use Reports (QRUR), which are only posted on the website. Physicians may access both their 2015 PQRS feedback reports and QRURs on the CMS Enterprise Portal using an Enterprise Identity Management account. For details on how to obtain your QRUR report, see “How to obtain a QRUR” on the CMS.gov webpage. For information on obtaining your PQRS report, see the “Quick Reference Guide for Accessing 2015 PQRS Feedback Reports.” For information on understanding your report, see the “2015 PQRS Feedback Report User Guide.” Both of the PQRS guides are available on the PQRS Analysis and Payment webpage. Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review. Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data. All informal review requests must be submitted electronically through the Quality Reporting Communication Support Page by December 7, 2016, at 11:59 p.m., ET. Physicians wishing to request an informal review of their QRUR and VM results should contact the Physician Value Help Desk at (888) 734-6433 (select option 3) or pvhelpdesk@cms.hhs.gov. CMS also has published the “2017 Value Modifier Informal Review Request Quick Reference Guide.” Practices will be contacted by email with a final decision from CMS within 90 days of the original request for an informal review. All decisions will be final, with no opportunity for further review. Practices that do not receive a response are encouraged to check their junk or spam email folders for the decision. For additional questions, please contact the QualityNet Help Desk at (866) 288-8912 [TTY: (877) 715-6222] or via qnetsupport@hcqis.org between the hours of 7 a.m. and 7 p.m., CT, Monday through Friday. For information regarding other Medicare physician quality programs that apply payment adjustments, please see the Value-Based Payment Modifier website. For step-by-step instructions on how to implement PQRS, view the How to Get Started page. Additionally, the California Medical Association (CMA) updated its resource, “2016 PQRS and Value-Based Modifier Getting Started Guide,” which is available free to CMA members in the resource library at www.cmanet.org. December 6, 2016 General, Medicare Medicare, PQRS, Value-Based Payment Modifier 0 0 Comment Read More »
Physicians have until November 30 to dispute 2015 PQRS and QRUR findings The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. Physicians who have concerns about the findings in their report(s) have until November 30 to file for an informal review of their data. The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully complete required PQRS reporting in 2015 will result in a 2 percent penalty in 2017. VM penalties can range from 1 to 4 percent, depending on the size of the practice and its performance on cost and quality measures. PQRS penalties will be communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS website. VM penalties can be found in the Quality and Resource Use Reports (QRUR), which are only posted on the website. Physicians may access both their 2015 PQRS feedback reports and QRURs on the CMS Enterprise Portal using an Enterprise Identity Management account. For details on how to obtain your QRUR report, see “How to obtain a QRUR” on the CMS.gov webpage. For information on obtaining your PQRS report, see the “Quick Reference Guide for Accessing 2015 PQRS Feedback Reports.” For information on understanding your report, see the “2015 PQRS Feedback Report User Guide.” Both of the PQRS guides are available on the PQRS Analysis and Payment webpage. Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review. Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data. All informal review requests must be submitted electronically through the Quality Reporting Communication Support Page by November 30, 2016, at 11:59 p.m., ET. Physicians wishing to request an informal review of their QRUR and VM results should contact the Physician Value Help Desk at (888) 734-6433 (select option 3) or pvhelpdesk@cms.hhs.gov. CMS also has published the “2017 Value Modifier Informal Review Request Quick Reference Guide.” Practices will be contacted by email with a final decision from CMS within 90 days of the original request for an informal review. All decisions will be final, with no opportunity for further review. Practices that do not receive a response are encouraged to check their junk or spam email folders for the decision. For additional questions, please contact the QualityNet Help Desk at (866) 288-8912 [TTY: (877) 715-6222] or via qnetsupport@hcqis.org between the hours of 7 a.m. and 7 p.m., CT, Monday through Friday. For information regarding other Medicare physician quality programs that apply payment adjustments, please see the Value-Based Payment Modifier website. For step-by step instructions on how to implement PQRS, view the How to Get Started page. Additionally, the California Medical Association (CMA) updated its resource, “2016 PQRS and Value-Based Modifier Getting Started Guide,” which is available free to CMA members in the resource library at www.cmanet.org. November 14, 2016 Managed Care, Medi-Cal, Medicare Quality Reporting, Medicare, Physician Quality Reporting System, PQRS 0 0 Comment Read More »
CMS extends Physician Compare preview period The Centers for Medicare and Medicaid Services (CMS) has extended the Physician Compare preview to November 16, 2015, to allow more time for physicians to preview their data for the 2014 quality measures that will be reported on the Physician Compare website later this year. The Affordable Care Act required CMS to create a website that would allow consumers to search for and compare physicians and other health care professionals who provide Medicare services. That site—the "Physician Compare" website, initially launched in 2010—provides contact information, specialties and clinical training, hospital affiliations and group practice information. In 2014, the website also began phasing in physician quality data from the Physician Quality Reporting System (PQRS), including the Group Practice Reporting Option, the Electronic Prescribing Incentive Program and the Electronic Health Record Meaningful Use Program. Physicians can access the preview site now via the PQRS portal-Provider Quality Information Portal. To learn more about which measures will be publicly reported and how to preview your measures, visit the Physician Compare Initiative page. If you have any questions about Physician Compare, public reporting or the 2014 quality measure preview period, please contact CMS at PhysicianCompare@Westat.com. November 9, 2015 Medi-Cal, Medicare Medicare, Physician Compare, Physician Quality Reporting System, PQRS, CMS 0 0 Comment Read More »
CMS announces 30-day period of Physician Compare On October 5, 2015 The Centers for Medicare and Medicaid Services (CMS) opened the 30-day preview period on October 5, 2015 for the 2014 quality measures that will be reported on the Physician Compare website later this year. The Affordable Care Act required CMS to create a website that would allow consumers to search for and compare physicians and other health care professionals who provide Medicare services. That site—the "Physician Compare" website, initially launched in 2010—provides contact information, specialties and clinical training, hospital affiliations and group practice information. In 2014, the website also began phasing in physician quality data from the Physician Quality Reporting System (PQRS), including the Group Practice Reporting Option, the Electronic Prescribing Incentive Program and the Electronic Health Record Meaningful Use Program. Physicians can access the preview site now through November 6, 2015 via the PQRS portal-Provider Quality Information Portal. To learn more about which measures will be publicly reported and how to preview your measures, visit the Physician Compare Initiative page. If you have any questions about Physician Compare, public reporting, or the 2014 quality measure preview period, please contact CMS at PhysicianCompare@Westat.com. October 31, 2015 Medicare Physician Quality Reporting System, PQRS, Quality Reporting, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS announces transition of single sign-on IACS system The Centers for Medicare and Medicaid Services (CMS) established the Individuals Authorized Access to the CMS Computer Services (IACS) as a means to provide a single user ID for business partners to access multiple CMS applications. For physician offices, this consists primarily of the Physician Quality Reporting System (PQRS)/eRx Physician Quality Reporting System and E-Prescribing Incentive Programs. CMS has announced that, on July 13, 2015, authorized users of the IACS system will be transitioned to the existing Enterprise Identity Management (EIDM) system. The EIDM system will allow a single user ID to access the new "PQRS Portal" section of the existing CMS Enterprise Portal, which is the current system that serves such programs as the PQRS Group Practice Reporting Option, Medicare Shared Savings Program for Accountable Care Organizations and Open Payments Program. To prepare for the transition, current IACS users will need to ensure their IACS account is active with a valid login, while new users will need to register for an EIDM account. Following the switch, users will be able to submit data, access reports and perform administrative tasks under the new PQRS Portal section. For additional assistance regarding IACS or EIDM, contact the QualityNet Help Desk at (866) 288-8912 FREE (TTY 1-877-715-6222 FREE) from 7 a.m. to 7 p.m. CT, Monday through Friday, or via email at qnetsupport@hcqis.org. Call Send SMS Call from mobile Add to Skype You'll need Skype CreditFree via Skype June 26, 2015 General CMS, PQRS, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMA updates physician guide to getting started with PQRS The California Medical Association (CMA) has just updated the “2015 PQRS and Value-Based Modifier Getting Started Guide,” free for physician members. The Medicare Physician Quality Reporting System (PQRS) was federally mandated by legislation and requires physicians to report quality information to Medicare or suffer a fee reduction in 2015. This guide will assist physicians in determining how to proceed with successful reporting. Contact: Michele Kelly, (213) 226-0338 or mkelly@cmanet.org. April 8, 2015 Medicare Physician Quality Reporting System, PQRS, Valued-Based Payment Modifier, Medicare 0 0 Comment Read More »
CMS extends PQRS reporting deadline for some reporting methods The Centers for Medicare and Medicaid Services (CMS) has extended the submission deadlines for two Physician Quality Reporting System (PQRS) reporting methods from February 28 to March 20 at 8 p.m., EST. The two affected reporting methods are: Direct electronic health record (EHR) submission or submission via a vendor using certified EHR technology Qualified clinical data registry (using the QRDA III format) reporting for PQRS and the clinical quality measure component of meaningful use for the EHR Incentive Program Submission timeframes for other PQRS reporting methods remain the same. CMS also recently extended the meaningful use attestation deadline for the 2014 Medicare EHR Incentive Program reporting period, also to March 20. For questions, please contact the Quality Net Help Desk at (866) 288-8912 or qnetsupport@hcqis.org from 7 a.m. to 7 p.m,. CT. For more information about PQRS, visit the CMS website. March 9, 2015 Medi-Cal, Medicare EHR, Physician Quality Reporting System, PQRS, CMS, Meaningful Use 0 0 Comment Read More »
