CMS accepts appeals for e-prescribing and PQRS

posted 01.24.12

The Centers for Medicare and Medicaid Services is starting an informal appeals process this month for the 2011 Physician Quality Reporting System and e-prescribing programs. Physicians may request an informal appeal through the QualityNet Help Desk and CMS will review the data to determine whether CMS made a mistake in calculating the penalty for not e-prescribing.  Contact the QualityNet Help Desk by phone at (866) 288-8912 or by e-mail at qnetsupport@sdps.org Monday - Friday from 7 a.m. - 7 p.m.  Potential informal appeal topics include the following. 

• You are not included on the list of eligible professionals able to participate in the program.
• You did not understand the percentage amount used to calculate your incentive (i.e., 2 percent, 1 percent, etc., of covered Medicare Part B services to fee-for-service patients).
• Your group National Provider Identifier (NPI) number was used on claims instead of your individual NPI.

Physicians needing help with e-prescribing or the Medicaid or Medicare electronic health record incentive programs can turn to the Texas regional extension centers. Currently, all four RECs provide low-cost consulting to primary care physicians, thanks to federal grants to offset the cost. Visit the Texas REC Resource Center on the TMA website at www.texmed.org/rec.

For questions on the federal EHR program or other office technologies, contact TMA’s Health Information Technology Department by phone at (800) 880-5720 or by e-mail at HIT@texmed.org.