CMS accepts appeals for e-prescribing and PQRS

Tags: news, centers for medicare and medicaid services, e-prescribing, physician quality and reporting system

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 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

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