Avoid the 2016 PQRS Penalty

Eligible professionals and group practices that fail to successfully report data on quality measures during 2014 will be subject to a two percent reduction on Medicare Fee Schedule amounts for services furnished by the eligible professional or group practice between January 1, 2016 and December 31, 2016.

To avoid the 2016 penalty, eligible professionals must meet one of the following criteria during the 2014 reporting period:

Individual Eligible Professional:
• Meets the criteria for satisfactory reporting adopted for the 2014 PQRS incentive, which are identified in the 2014 Medicare PFS Final Rule and in PQRS educational materials available on the PQRS website. Meeting the criteria will also ensure a PQRS incentive payment equal to 0.5 percent of estimated Medicare Part B allowed charges for covered professional services in 2014.

Or

• Participates in PQRS via qualified clinical data registry, qualified registry, or claims reporting and reports at least three measures covering one National Quality Strategy domain for at least 50 percent of the eligible professional’s Medicare Part B FFS patients.

Group Practice:
• Meets the Group Practice Reporting Option (GPRO) requirements for satisfactory reporting (which are similar to the criteria for satisfactory reporting for the 2014 PQRS incentive), as identified in the 2014 Medicare PFS Final Rule and in PQRS educational materials available on the PQRS website.

Or

• Participates in PQRS via qualified registry reporting and reports at least three measures covering one NQS domain for at least 50 percent of the group practice’s Medicare Part B FFS patients. Read more.

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About MSNJ

Founded in 1766, the Medical Society of New Jersey is the oldest professional society in the United States. The organization and its dues-paying members are dedicated to a healthy New Jersey, working to ensure the sanctity of the physician–patient relationship. In representing all medical disciplines, MSNJ advocates for the rights of patients and physicians alike, for the delivery of the highest quality medical care. This allows response to the patients’ individual, varied needs, in an ethical and compassionate environment, in order to create a healthy Garden State and healthy citizens.

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