Frequently Asked Questions

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Why does CMS reference 2017 PQRS payment adjustments when the 2016 reporting period affects 2018 PQRS payment adjustments?

The 2017 payment adjustment reference is included because eligible professionals (EPs) that participated in a Medicare Shared Savings Program ACO that failed to report quality data for 2015 for the 2017 PQRS payment adjustment period, have available a special secondary PQRS reporting period in 2016 that enables the EPs to avoid the 2017 PQRS payment adjustment and the 2017 Value Modifier (VM) automatic downward adjustment.

Affected EPs may submit 2016 PQRS quality data under one of the available reporting options for this special secondary reporting period. This data is submitted outside the ACO by EPs in order to avoid the 2017 PQRS payment adjustment and 2017 VM automatic downward adjustment.


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