Physicians Advised to Avoid Payment Reductions

In order to avoid an automatic negative two percent Value Modifier payment adjustment in calendar year (CY) 2016, physicians and other health professionals in groups of ten or more must satisfy the Physician Quality Reporting System (PQRS) requirements as a group or as individuals in CY 2014. Medicare will not apply the CY 2016 Value Modifier to a group of physicians if one or more physicians in the group participate in the Medicare Shared Savings Program, the Pioneer ACO Model, or the Comprehensive Primary Care Initiative in CY 2014. The deadline for groups to register to participate in the PQRS Group Practice Reporting Option (GPRO) as a group in CY 2014 has passed. Therefore, in order to avoid the automatic Value Modifier payment adjusment in CY 2016, groups with ten or more EPs that did not register to participate in the PQRS in CY 2014, must have at least 50% of the EPs in the group participate in the PQRS as individuals in CY 2014 and meet the criteria to avoid the CY 2016 PQRS payment adjustment. No registration is necessary for a group if the EPs in the group participate in the PQRS as individuals. For questions about the sign-up process, or participating in the 2014 PQRS as a group or individual, please contact the QualityNet Help Desk at 1(866) 288-8912 or via email at qnetsupport@hcqis.org. For questions about the Value Modifier please contact the Physician Value (PV) Help Desk at 1(888) 734-6433 (select option 3).