PQRS Negative Payment Adjustment

During November, the Centers for Medicare and Medicaid Services (CMS) began notifying Eligible Professionals (EPs) subject to the 2015 Physician Quality Reporting System (PQRS) negative payment adjustment. Effective Jan. 1, 2015, CMS will apply a negative PQRS payment adjustment of 1.5 percent to payments under the Medicare Physician Fee Schedule for individual EPs and group practices that did not meet the reporting criteria for the applicable period. 

CMS views the PQRS as part of the effort to transform the health care delivery system by linking Medicare reimbursements to the quality of care delivered to Medicare beneficiaries. Critical to the PQRS process is the requirement that individual EPs and group practices participate in reporting quality metrics. Failure to participate in one of the quality reporting initiatives will result a negative payment adjustment beginning in 2015.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827