Washington Connection, Nov. 16, 2017
Written by: MGMA Government Affairs

Dec. 1: Last day to submit a PQRS or Value Modifier penalty appeal 

MGMA successfully lobbied CMS to reduce the 2018 financial risk associated with the retired Medicare reporting programs, including PQRS and the Value-Based Payment Modifier (VM). However, these programs will continue to impact Medicare Part B reimbursement for services furnished in 2018. Groups that achieved high quality and low cost scores based on calendar year 2016 data may see a payment bonus, whereas groups that did not meet PQRS reporting criteria will face a penalty. If you feel that a penalty is unwarranted or CMS incorrectly calculated your group's quality and cost data, you have until Dec. 1 to appeal by submitting an informal review request, after which point penalties will not be reversed. Learn more by downloading MGMA’s “What Practice Leaders Need to Know: Medicare’s Quality and Cost Feedback” resource.


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