atom Alliance team members will help you understand upcoming changes coming to the Physician Quality Reporting System (PQRS), how to use your 2014 data and how these two are related.

Change Coming in 2016
The Centers for Medicare & Medicaid Services (CMS) will apply a negative payment adjustment to individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites and group practices participating in the PQRS group practice reporting option (GPRO) (including Accountable Care Organizations [ACOs]) that did not satisfactorily report PQRS in 2014. Individuals and groups that receive the 2016 negative payment adjustment will not receive a 2014 PQRS incentive payment.

EPs, CPC practice sites, PQRS group practices and ACOs that believe they have been incorrectly assessed for the 2016 PQRS negative payment adjustment may submit an informal review until Nov. 9, 2015, requesting that CMS investigate incentive eligibility and/or payment adjustment determination.

All informal review requestors will be contacted by CMS via email of a final decision within 90 days of the original request for an informal review. All decisions are final.

All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP), available until Nov. 9, 2015, under the Related Links section of the Physician and Other Health Care Professionals Quality Reporting Portal.

Please see How to Request an Informal Review of 2014 PQRS Incentive Eligibility and 2016 PQRS Negative Payment Adjustment for more information.

For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or [email protected] Monday-Friday from 7 a.m. to 7 p.m. CT/8 a.m. to 8 p.m. ET.

2014 Annual Quality and Resource Use Reports Available
The 2014 Annual Quality and Resource Use Reports (QRURs) are now available for every group practice and solo practitioner nationwide.

The QRURs are also available for groups and solo practitioners that participated in the Medicare Shared Savings Program, the Pioneer ACO Model, or the CPC initiative in 2014, and to some non-physician EPs.

The 2014 Annual QRURs show how groups and solo practitioners performed in 2014 on the quality and cost measures used to calculate the 2016 Value Modifier.

Authorized representatives of group and solo practitioners can access the 2014 Annual QRURs on the CMS Enterprise Portal using an Enterprise Identify Data Management (EIDM) account with the correct role. For more information on how to access the 2014 Annual QRURs, visit How to Obtain a QRUR.