New QRURs Released by CMS

The Centers for Medicare and Medicaid Services (CMS) identified issues that impacted the 2014 Annual Quality and Resource Use Reports (QRURs) released on Sept. 8, 2015. As previously noted, CMS identified issues with data submitted via electronic health record (EHR) and ALL Qualified Clinical Data Registries (QCDR), as well as a technical issue with the claims used to calculate claims-based measures. CMS has successfully corrected these issues and produced revised 2014 Annual QRURs, which are now available via the CMS Enterprise Portal. For a small percentage of groups, this correction resulted in a change to their Value-Based Payment Modifier (Value Modifier) calculation, and these groups will receive a separate notification.

The 2014 Annual QRURs show how groups and solo practitioners performed in 2014 on the quality and cost measures used to calculate the 2016 Value Modifier. For groups with 10 or more eligible professionals (EPs) that are subject to the 2016 Value Modifier, the QRUR shows how the Value Modifier will apply to physician payments under the Medicare Physician Fee Schedule (MPFS) for physicians who bill under the group in 2016. For all other groups and solo practitioners, the QRUR is for informational purposes only and will not affect their payments under the MPFS in 2016.

How to access your TIN’s revised 2014 Annual QRUR

Authorized representatives for a group or solo practitioner can access the 2014 Annual QRURs on the CMS Enterprise Portal using an Enterprise Identify Data Management (EIDM) account with the correct role. For more information on how to access the 2014 Annual QRURs, visit How to Obtain a QRURon CMS’s website.

For groups with 10 or more EPs that are subject to the 2016 Value Modifier, CMS established an Informal Review Period to request a correction of a perceived error in their 2016 Value Modifier calculation. The informal review period for the 2016 Value Modifier is open through Nov. 23, 2015, at 11:59 p.m. ET; therefore, we strongly encourage that you access and review your TIN’s QRUR as soon as possible.

Additional information about the 2014 Annual QRURs, and how to request an informal review, is available on the 2014 QRUR website and through the QRUR Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option three).