For a second time, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for eligible individuals and groups that believe they have been incorrectly identified for the 2016 Physician Quality Reporting System (PQRS) negative payment adjustment to submit an informal review request. Such requests are now due to CMS before Wednesday, Dec. 16, 2015 at 11:59 p.m. Eastern Time.
As previously reported, eligible professionals, comprehensive primary care practice sites, PQRS group practices, and accountable care organizations participating in the PQRS group practice reporting option that did not adequately report to PQRS in 2014 will receive a negative payment adjustment and will not receive a scheduled 2014 PQRS incentive payment from CMS in 2016.
Informal review requests must be submitted electronically via the Quality Reporting Communication Support Page. According to CMS, all requests to investigate PQRS incentive eligibility and/or payment adjustment determination will receive a response via email from CMS with its decision within 90 days. All decisions will be final and there will be no further review.
Please see "2014 PQRS: Incentive Eligibility & 2016 Negative Payment Adjustment Informal Review Made Simple" for more information. You may also contact the CMS QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org. Please do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number, in any e-mail to the QualityNet Help Desk.
ASCO will continue to monitor CMS announcements and share updates with ASCO members. Keep checking ASCO in Action, for future developments.