Please note that this article contains information that is only relevant to American clinics.
On September 26, 2016, the Centers for Medicare and Medicaid (CMS) released the 2015 PQRS Feedback Report and the 2015 Quality and Resource Use Report (QRUR). These annual reports provide valuable insights into how physician groups and sole practitioners performed over the course of the 2015 calendar year. The Feedback and QRUR reports also enables them to determine whether you are subject to the 2017 PQRS negative payment adjustment and the 2017 Value Modifier payment adjustment.
In 2015, if an individual EP or PQRS group practice did not satisfactorily report or satisfactorily participate while submitting data on PQRS quality measures, a 2% negative payment adjustment applies in 2017.
Before you can obtain access to said reports and figure out whether you’ll need to implement any payment adjustments in 2017, you need to register for an EIDM account.
If you do not have an EIDM account, click here to sign up for one.
The CMS website has a lot of helpful information about the nature of negative payment adjustments. It also discusses what to do in the event that you receive a negative payment adjustment. And most importantly, the website tells you how to avoid these situations going forward.
The CMS has very strict guidelines when it comes reporting on quality measures. Fortunately, Practice Perfect include several measures that will prevent you from sending claims if the relevant PQRS measurements have not been updated. Don’t let your clinic take a financial blow because the criteria were not met.