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Informal Review for 2016 Value Modifier and 2016 PQRS Payment Adjustment Extended to December 16

The informal review period for the 2016 Value Modifier has been extended. All requests must be submitted by 11:59pm ET on December 16, 2015. The informal review process allows groups (as identified by their taxpayer identification number) with 10 or more eligible professionals that are subject to the 2016 Value Modifier to request a correction of a perceived error in their Value Modifier calculations. 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 ...

Avoid the Medicare Quality Reporting Penalty in 2015

By the Alameda-Contra Costa Medical Association As part of the Physician Quality Reporting System (PQRS), Medicare will impose a 1.5% penalty in 2015 on physicians and other providers who do not successfully report at least one individual quality measure for at least one patient in 2013. The purpose of this article is to help physicians avoid the penalty in 2015 by providing guidance on how to report at least one measure for at least one patient using Medicare claims. Since most physicians already submit Medicare claims for reimbursement, adding the ...

Act Now to Avoid Medicare Penalties in 2015

By the California Medical Association (CMA) Over the past six years, the Centers for Medicare and Medicaid Services (CMS) has launched a number of initiatives that offer physicians the opportunity to increase their net revenue by participating in quality reporting programs. Until now, these programs have been voluntary, and physicians have received bonuses for participating. That’s about to change. Failure to participate now means physicians could face significant penalties. The American Academy of Family Physicians estimates that participating in these initiatives in 2013, rather than waiting until 2014, could save a ...