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Monday, December 7, 2015

Appeal Medicare Penalties by Dec. 16 to Avoid Pay Cut

What a mess at the Centers for Medicare & Medicaid Services (CMS). What? You’re not surprised? You might be if you end up getting your Medicare payments cut by 2 percent next year. What’s worse is this could happen to those very physicians who’ve actually been trying to understand and comply with Medicare’s Physician Quality Reporting System and Value-Based Payment Modifier programs. The mess stems from “issues” with data submitted to CMS for those two programs and “issues” with how CMS used that data to calculate bonuses or penalties. “CMS’ failure to provide transparent, clear, and timely information on the various data problems and the system glitches that have impeded accurate calculation of 2016 adjustments has led to mass confusion,” American Medical Association CEO James Madara, MD, wrote in a letter asking CMS to grant a waiver for all physicians or at least extend the appeal deadline. TMA President Tom Garcia is following up today with a strongly worded letter to the Texas congressional delegation. The key to remember is if you’re confused or concerned that you might get a penalty, file an appeal with CMS by Dec. 16. Look for a special issue of TMA’s Action newsletter tomorrow with all the details.

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