September 27, 2016
CMS Announces Release of 2017 PQRS Payment Adjustment Notifications
The Centers for Medicare & Medicaid Services (CMS) announced the release of 2017 negative payment adjustment notifications for the Physician Quality Reporting System (PQRS) on September 26, 2016.
Eligible professionals (EPs) failing to satisfactorily participate in PQRS in 2015 will incur a 2.0 percent reduction for all Medicare Part B Physician Fee Schedule payments in 2017. Negative payment adjustments sent to individual EPs are indicated with a Tax Identification Number (TIN) and National Provider Identifier (NPI) combination and apply only to the EP and not his/her affiliated clinic or facility. Group practices receiving a negative payment adjustment notification are identified with a TIN only and apply to all EPs whose billing rights have been assigned to the TIN.
Practices and/or EPs that believe their 2017 negative payment adjustment is incorrect may submit an informal review request to CMS via the Quality Reporting Communication Support Page by November 30, 2016 at 11:59 p.m. EST. CMS will respond with a decision within 90 days of submission. For additional information about how 2016 PQRS reporting will impact 2018 payment adjustments, visit the PQRS webpage.
PQRS and the Value Modifier program will be replaced with the Quality Payment Program which allows for flexible reporting options for the first year of the program, beginning January 1, 2017.
To learn more about components of the Quality Payment Program, please visit the ASA MACRA webpage.