If you have reviewed your 2014 AQRUR and think that:
- you have been incorrectly assessed the 2016 PQRS negative payment adjustment (-2.0% of 2016 Medicare FFS payments) OR
- there is a perceived error in your 2016 VM calculation (applicable to groups of 10+ Eligible Professionals as identified by Tax ID Number/TIN)
you can submit an informal review request for CMS to investigate your incentive eligibility and/or payment adjustment determination.
Submit your request through the Quality Reporting Communication Support Page (CSP). All informal review requestors will be contacted via email of a final decision by CMS within 90 days of the original request for an informal review. All decisions will be final and there will be no further review.
CMS has provided this guide: 2014 Physician Quality Reporting System (PQRS): Incentive Eligibility & 2016 Negative Payment Adjustment - Informal Review Made Simple
For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number (TIN), in e-mail inquiries to the QualityNet Help Desk.
Additional information about the 2014 QRURs and how to request an informal review is available on the 2014 QRUR website and through the QRUR Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).
Don't forget to check out the free CSMS webinar series for basic information about Medicare quality programs (PQRS, AQRUR, VM).
The webinars are available for download as PDFs and as recordings (.wmv files). Click here to learn more.
