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Action Required by October 18 to Avoid Certain Medicare Payment Cuts
Posted on: 10/11/2013

As we reported in the past, all eligible physicians who bill Medicare and choose not to participate in the Physician Quality Reporting System (PQRS) during the 2013 reporting period, either as an individual or as part of a group, may be subject to a 1.5 percent penalty to their Medicare reimbursements in 2015. (Those who successfully participate in PQRS may quality for a 0.5 percent increase.)

Physicians who are not currently reporting PQRS data should register with the Centers for Medicare and Medicaid Services (CMS) by Oct. 18, 2013, for the administrative claims reporting option in order to avoid the 1.5 percent penalty. (This website will not be ;available after October 18.) If you are currently reporting, no action is needed.

Take these steps to get started

Once at the CMS website, select "Login to CMS Secure Portal" on the right-hand column. Accept terms and conditions and log in. Next, select the "PV-PQRS" tab at the top of the screen and select "Registration" from
the drop-down menu.   

Please note: To use the registration website, you must have an "Individuals Authorized Access to the CMS Computer Services (IACS)" number. Get your IACS number here.

What is this IACS number? CMS established this single user ID as a means for you to access its applications.

But that's not all. As directed by the Affordable Care Act, CMS may apply an additional 1 percent Value-Based Modifier (VBM)* penalty in 2015 to Medicare payments of physicians in groups of 100 or more who did not engage in PQRS group participation for 2013.

For members only - find more information on PQRS in this Issue Brief. 

Also, visit our PQRS web page for all the latest.

Questions? Call the CMS hotline at 1-888-734-6433, 7 a.m. - 7 p.m. (calls accepted during the government shut-down), or contact your ISMS Advocacy Team at 800-782-4767 ext. 1470 or by email.

*The Value-Based Modifier provides for variations of payment to a physician or group of physicians under the Medicare Physician Fee Schedule, based upon the quality of care provided compared to cost during a particular performance period.

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