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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 Desk at pvhelpdesk@cms.hhs.gov or at (888) 734-6433 (select option 3).

2016 PQRS Payment Adjustment: Informal Review Deadline Extended to December 16

CMS is extending the 2014 Informal Review period. Individual eligible professionals, Comprehensive Primary Care practice sites, Physician Quality Reporting System (PQRS) group practices, and Accountable Care Organizations that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustment have until 11:59pm ET on December 16, 2015, to submit an informal review, requesting CMS investigate incentive eligibility and/or payment adjustment determination. 

  • 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 are final and there will be no further review.
  • Requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP).
  • Informal review will experience downtime from December 3 through December 7, 2015. If you plan to file an informal review request, please do so outside of this window.
  • See the factsheet and Analysis and Payment webpage for more information.

For additional questions, contact the QualityNet Help Desk at (866) 288-8912 [TTY 1 (877) 715-6222] or via qnetsupport@hcqis.org from 7am to 7pm CT Monday through Friday.

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