PQRS Appeal Deadline for 2013 Reporting

Date: February 6, 2015

Are you being penalized in 2015 for failure to succeed with PQRS reporting in 2013?  If you believe that you met the reporting criteria in 2013 and want to appeal, the deadline to submit an appeal is February 28, 2015.

The process for filing the appeal can be found on the CMS website at:  http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2013-PQRS-Incentive-Eligibility-and-New-2015-Negative-Payment-Adjustment-Informal-Review-Made-Simple.pdf

Successful reporting in 2013 required you to meet one of the following criteria:

  1. Meet the criteria for satisfactory reporting for the 2013 PQRS Incentive (earn a bonus)
  2. Report one (1) valid measure or measures group using the claims, registry, or EHR-based reporting mechanisms
  3. Elect to be analyzed under the administrative claims-based reporting mechanism

Once your appeal has been received, you will receive a determination within 90 days.  This is an informal process and the decision is final with no additional appeal rights.  If more than one provider failed and is being penalized, you must submit appeals for each individual provider.

Do not delay if you want to appeal the decision as the deadline is fast approaching.  For additional assistance with PQRS this year, you may purchase our 2015 PQRS monograph at:  https://www.corcoranccg.com/products/monographs/2014-physician-quality-reporting-system/

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