{"id":635,"date":"2016-09-29T07:30:28","date_gmt":"2016-09-29T13:30:28","guid":{"rendered":"https:\/\/dsiohn098w.mpqhf.org\/blog\/?p=635"},"modified":"2016-11-08T13:25:48","modified_gmt":"2016-11-08T20:25:48","slug":"hts-pqrs-pqrs-negative-payment-adjustment-notification-letters","status":"publish","type":"post","link":"https:\/\/dsiohn098w.mpqhf.org\/blog\/hts-pqrs-pqrs-negative-payment-adjustment-notification-letters\/","title":{"rendered":"HTS &#8211; PQRS: The PQRS Negative Payment Adjustment Notification Letters"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2016\/09\/09282016-PQRS-Adjustment-Letters.png\" alt=\"09282016-PQRS-Adjustment-Letters\" width=\"1200\" height=\"300\" class=\"alignnone size-full wp-image-638\" srcset=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2016\/09\/09282016-PQRS-Adjustment-Letters.png 1200w, https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2016\/09\/09282016-PQRS-Adjustment-Letters-300x75.png 300w, https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2016\/09\/09282016-PQRS-Adjustment-Letters-768x192.png 768w, https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2016\/09\/09282016-PQRS-Adjustment-Letters-1024x256.png 1024w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/p>\n<h1>The PQRS Negative Payment Adjustment Notification Letters<\/h1>\n<h5>September 29, 2016<\/h5>\n<h6>Written by Sarah Leake<\/h6>\n<p>Soon, CMS will begin distributing letters to each Eligible Professional who did NOT satisfactorily report 2015 PQRS quality measures.  The purpose of this letter is to inform each individual or group who will be receiving a 2.0% reduction on all their 2017 Medicare Part B Physician Fee Schedule payments.  The good news is the majority of eligible professionals successfully reported PQRS in 2015 so fewer of you will be receiving this letter than last year!  This letter pertains <strong>only to the PQRS program<\/strong> and, if you received this letter, you could also be subjected to additional negative adjustments under the Value Modifier program.<\/p>\n<p>If you do receive one or more of these letters, here are the important things to know.<\/p>\n<p><strong>FIRST<\/strong>, determine who is affected by the payment reduction.  Look at the number in the upper LH corner of letter.  Is it just the Tax Identification Number (TIN) or does it also contain the TIN plus the National Provider Identifier (NPI) number for a TIN\/NPI combination number?<\/p>\n<ul>\n<li>If a letter is sent to individual EPs, a TIN\/NPI combination number will be listed and the adjustment applies <strong>only<\/strong> to the individual EP associated with the TIN\/NPI noted within the letter and <strong>not<\/strong> the clinic or facility. <\/li>\n<li>If the letter is sent to PQRS group practices, a TIN only is listed and the adjustment <strong>applies to all<\/strong> EPs who have reassigned their billing rights to the TIN. <\/li>\n<\/ul>\n<p><strong>SECOND<\/strong>, understand your options. <\/p>\n<ul>\n<li>Submit an informal review if you believe the negative payment adjustment is being applied in error.  This would be an appropriate step if you submit 2015 PQRS quality measures and are getting a negative payment adjustment.  Review the PQRS feedbacks to learn more about why CMS is giving this adjustment.<\/li>\n<li>Deadline to submit the informal review is <strong>November 30<\/strong>.<\/li>\n<li>CMS will investigate and issue a decision within 90 days of receipt.<\/li>\n<li>Informal review requests are submitted via a web-based tool at: <\/li>\n<p>        <a href=\"https:\/\/www.qualitynet.org\/portal\/server.pt\/community\/informal_review_request\/\" target=\"_blank\">Quality Reporting Communication Support Page<\/a>\n<\/ul>\n<p><strong>Please note \u2013 this link is for an Informal Review for PQRS only.  To submit an Informal Review for the Value Modifier, please use the Informal Review option located in EIDM in the PV-PQRS section.<\/strong><\/p>\n<ul>\n<li>If you did not submit 2015 PQRS quality measures, there are no hardship exemptions for the PQRS negative payment adjustment.<\/li>\n<\/ul>\n<p>For further information regarding the 2017 PQRS negative payment adjustment, please see the <a href=\"https:\/\/www.cms.gov\/Medicare\/Quality-Initiatives-Patient-Assessment-Instruments\/PQRS\/Payment-Adjustment-Information.html\" target=\"_blank\">PQRS Payment Adjustment Information webpage<\/a>.<\/p>\n<p><strong>THIRD<\/strong>, prepare for 2016 PQRS quality measure submission.<\/p>\n<ul>\n<li>If you will be getting a negative payment adjustment in 2017, you will want to review your approach to reporting PQRS quality measures for 2016 to avoid negative payment adjustments in the future.  Our staff is available to discuss your strategy and answer your questions.<\/li>\n<\/ul>\n<p>Please see other blog posts about important information on the Value Modifier program and any adjustments which may occur under the Value Modifier program.<\/p>\n<p>&nbsp;<\/p>\n<p>Leave a reply, ask a question or share information using the \u201cLeave a Reply\u201d section below, or email <a href=\"mailto:sleake@mpqhf.org?subject=PQRS Blog Website\" target=\"_blank\">Sarah Leake<\/a> directly with your questions or comments.<\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/pqrs\/\" target=\"_blank\">Read all previous posts<\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/mu\/\" target=\"_blank\">See Meaningful Use Blog<\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/macra\/\" target=\"_blank\">See MACRA-QPP Blog<\/a><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n<p><strong>Subscribe to the HTS PQRS Blog<\/strong><br \/>\n<a href=\"http:\/\/eepurl.com\/ccEHi1\" class=\"su-button su-button-style-flat\" style=\"color:#ffffff;background-color:#385173;border-color:#2d415c;border-radius:5px\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color:#ffffff;padding:0px 30px;font-size:22px;line-height:44px;border-color:#74869d;border-radius:5px;text-shadow:0px 0px 0px #f4f4f4\"> Subscribe<\/span><\/a>\n<p>&nbsp;<\/p>\n<hr \/>\n<div id=\"boxzero\">\n<section id=\"boxone\">\n<p id=\"boxparagraph\"><strong>See a list of upcoming webinars<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/upcoming-webinars\/\"><span class=\"link-spanner\">See a list of upcoming webinars<\/span><\/a><br \/>\n<\/section>\n<section id=\"boxtwo\">\n<p id=\"boxparagraph\"><strong>Check out any webinars you missed<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/webinar-materials\/\"><span class=\"link-spanner\">Check out any webinars you missed<\/span><\/a><br \/>\n<\/section>\n<aside id=\"boxthree\">\n<p id=\"boxparagraph\"><strong>See our PQRS resources<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/pqrs\/\"><span class=\"link-spanner\">See our PQRS resources<\/span><\/a><br \/>\n<\/aside>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The PQRS Negative Payment Adjustment Notification Letters September 29, 2016 Written by Sarah Leake Soon, CMS will begin distributing letters to each Eligible Professional who did NOT satisfactorily report 2015 PQRS quality measures. The purpose of this letter is to inform each individual or group who will be receiving a 2.0% reduction on all their [&hellip;]<\/p>\n","protected":false},"author":13,"featured_media":425,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[72],"tags":[],"class_list":{"0":"post-635","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-pqrs","8":"entry"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>HTS - PQRS: The PQRS Negative Payment Adjustment Notification Letters - Mountain Pacific Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/hts-pqrs-pqrs-negative-payment-adjustment-notification-letters\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HTS - PQRS: The PQRS Negative Payment Adjustment Notification Letters - Mountain Pacific Blog\" \/>\n<meta property=\"og:description\" content=\"The PQRS Negative Payment Adjustment Notification Letters September 29, 2016 Written by Sarah Leake Soon, CMS will begin distributing letters to each Eligible Professional who did NOT satisfactorily report 2015 PQRS quality measures. 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