nhcma at a glance

Become A Member

For over 225 years, NHCMA has represented the voice of New Haven County physicians and their patients. We offer not just a wealth of benefits, like networking events, discounts, action alerts and workshops, we also give you and your patients a way to get involved in the fight for the future of health care.

click for complete member benefits

Action Alerts

Don't be left behind! Find out the latest news, whether it's a policy change, a contract change, billing and coding news and alerts or anything else that affects the way you practice medicine.

see action alerts in your area

Calendar of Events

NHCMA's Event Calendar includes a variety of valuable seminars and events. Our goal is to offer our physician members and their staffs the knowledge and resources necessary to manage a successful practice.

launch event calendar

Physician Locator

Looking for a doctor who supports quality patient care? Search our directory of NHCMA members for a physician in your community. You can search by speciality or geographic location.

find a doctor

December 2, 2016

AMERICAN MEDICAL ASSOCIATION

DEADLINE FOR INFORMAL REVIEW OF POTENTIAL PENALTIES EXTENDED

Physicians who want to contest potential payment penalties associated with the Physician Quality Reporting System (PQRS) and/or the Value Modifier (VM) now have until December 7 to file a request for an informal review of their data.  Previously, the deadline to request a review was November 30 but the Centers for Medicare and Medicaid Services announced yesterday that the deadline will be extended by one week.

The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act.  Failure to successfully complete required PQRS reporting will result in a 2% penalty.  Value Modifier penalties can range from 1% to 4% depending on the size of the practice and its performance on cost and quality measures.  PQRS penalties were communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS web site.  Value Modifier penalties and bonuses can be found in Quality and Resource Use Reports (QRURs) posted on the web site only.

Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review.  Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data. 

To File A Request for PQRS Informal Review:
Go to the Quality Reporting Communication Support Page (CSP), select “related links” in communication support page in the upper left-hand corner, then select “informal review request” followed by “”PQRSs informal review” and fill out requested information when new page opens.

If you have not already done so, 2015 PQRS feedback reports can be accessed on the CMS Enterprise Portal using an Enterprise Identity Management (EIDM) account. See PQRS Analysis and Payment webpage for more information.

For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or TIN, in e-mail inquiries to the QualityNet Help Desk.


 To File A Request for VM Informal Review:
For information on how to file, see the 2017 Value Modifier Informal Review Request Quick Reference Guide.

For More Information, see:How to Obtain a Quality and Resource Use Report (QRUR) webpage and/or  2015 QRUR and 2017 Value Modifier webpage. 

Help Desk Information: For EIDM, contact the QualityNet Help Desk at qnetsupport@hcqis.org or 866-288-8912 (TTY 877-715- 6222);  For QRURs or the Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3)