Individual eligible professionals (EPs), designated support staff/vendors, and group practices that believe they have been incorrectly assessed the 2016 Physician Quality Reporting System (PQRS) negative payment adjustment may request to have an informal review of their PQRS reporting performance. The Centers for Medicare and Medicaid Services (CMS) recently extended the deadline for submitting an Informal Review request to December 16, 2015. All requests must be submitted electronically by 11:59 p.m. Eastern Time on December 16, 2015, via the Quality Reporting Communication Support Page (CSP).

An informal review may be requested if the feedback report reveals that the individual EP or group practice did not earn the applicable PQRS incentive payment when they believe they should have, when they believe the payment amount was incorrect, or if they disagree with the analysis of satisfactory reporting to avoid a future payment adjustment.

Please note, CMS warns that the system will experience downtimes during the weekend of December 3-7, 2015, so physicians and other eligible professionals should plan to file their informal reviews outside of that window.

Check-out the CMS document, 2014 PQRS: Incentive Eligibility & 2016 Negative Payment Adjustment Informal Review Made Simple, to help walk you through the process.