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PQRS – Informal Review Process for 2016 Negative Payment Adj


If you DID NOT satisfactorily report PQRS in 2014, then CMS will apply a NEGATIVE payment adjustment to qualifying providers & groups during the calendar year 2016.

September 9, 2015 through December 16, 2015 – PQRS Informal Review Process  (NOTE: DEADLINE EXTENDED)

Qualifying providers/groups that believe they were incorrectly assessed during the 2014 reporting period for the 2016 negative payment adjustment may submit an informal review now until 11:59 p.m. EST on Dec. 16, 2015 to CMS requesting that they review incentive and payment adjustment eligibility based on the 2014 reporting period. According to CMS, all informal review requestors will be contacted via email of a final decision by CMS within 90 days of the original request for an informal review and all decisions will be final and there will be no further review or appeal.

To Submit An Informal Review: Must be submitted electronically through the Quality Reporting Communication Support Page (CSP). The page is now available until Dec. 16, 2015: Visit and click on the ‘Communication Support Page’ under the ‘Related Links’ section.


For more information visit: and for questions please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or [email protected].