2016 PQRS Feedback Reports and Annual QRURs Available

As noted in last week’s listserv message, the 2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs), which contain performance and payment adjustment information, are now available. Please note the following about these reports:

The payment adjustments shown in the reports are based on proposals that were included in the 2018 Medicare Physician Fee Schedule Proposed Rule (https://federalregister.gov/d/2017-14639).

  • Reducing the automatic downward Value-Based Payment Modifier (Value Modifier) adjustment by half for practices that did not meet the minimum quality reporting requirements;
  • Holding all practices that met the minimum quality reporting requirements harmless from downward Value Modifier payment adjustments based on performance;
  • Reducing the maximum upward Value Modifier payment adjustment for performance for large practices to align with the adjustment for small and solo practices.
  • Reducing the number of measures that must be satisfactorily reported for the 2016 PQRS to avoid the 2018 downward payment adjustment from 9 measures across 3 National Quality Strategy domains to 6 measures with no domain requirement.

If the policies are not finalized as proposed, we will provide an update to report recipients.

To find out which reports are available for your practice and your current and past PQRS and Value Modifier payment adjustments, you can use the new Payment Adjustments and Reports Lookup feature on the CMS Enterprise Portal. An Enterprise Identify Management (EIDM) account is not needed to use this feature. Instructions for using this feature are located in the “Guide for Accessing the Payment Adjustment and Reports Lookup Feature”.

If you perceive that 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 that will close on December 1, 2017, at 8 p.m. ET.

An EIDM account with the appropriate role is required for participants to obtain their 2016 PQRS feedback reports and 2016 Annual QRURs. Both reports can be accessed on theCMS Enterprise Portal using the same EIDM account. Visit the How to Obtain a QRUR webpage for instructions on accessing both reports.

For more information on your PQRS feedback report:

For more Information on your Annual QRUR:

For the 2016 reporting period, the majority of EPs successfully reported to PQRS and avoided the downward payment adjustment. Under the new Quality Payment Program, CMS is anticipating that this trend of success will continue. The Quality Payment Program began January 2017 and replaces PQRS, the Value Modifier program, as well as the separate payment adjustments under the Medicare Electronic Health Record (EHR) Incentive Program for eligible professionals. The Quality Payment Program streamlines these legacy programs, reduces quality reporting requirements and offers many flexibilities that allow eligible clinicians to pick their pace for participating in the first year. To prepare for success in the Quality Payment Program, we encourage EPs to review their PQRS feedback report, Annual QRUR, and visit qpp.cms.gov to learn about the Quality Payment Program.

Questions:

Both help desks are available Monday through Friday from 7:00 am to 7:00 pm CT.

Source: Centers for Medicare & Medicaid Services Email Newsletter Thursday, September 28, 2017.

  • September 29, 2017
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