Wondering if you will be subject to 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and the Value Modifier? Late last month, the Centers for Medicare and Medicaid Services (CMS) posted information on its website that physicians can consult to determine whether they will be subject to penalties. Practices with concerns have until Nov. 30 to file for an informal data review.
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Failure to successfully complete required PQRS reporting will result in a 2% penalty. Value Modifier penalties can range from 1% to 4% depending on the practice size and its performance on cost and quality measures. PQRS penalties will be communicated to physicians by U.S. mail, as well as in the PQRS feedback reports posted on the CMS website. However, Value Modifier penalties and bonuses can be found online only in the Quality and Resource Use Reports.
If you are uncertain about your penalty status, you can submit a request for informal review. In most cases a successful PQRS review will trigger an automatic review of related VM penalties, but program officials say the safest course is to file requests for review of both PQRS and VM data.
For questions about the 2015 Annual QRUR, 2017 Value Modifier, and how to request an informal review of the 2017 Value Modifier, contact the Physician Value Help Desk.
- Monday – Friday: 8:00 am – 8:00 pm EST
- Phone: 1-888-734-6433 (select option 3)
- Email: email@example.com
Note: These penalties stem from policies in effect prior to the enactment of MACRA.