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5/31/2011 | CMS e-Prescribing Penalties |
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| There have been tremendous concerns with the Center for Medicare and Medicaid Services' (CMS) e-prescribing penalty. To avoid penalties in 2012 (1 percent of Medicare Part B claims), PCMS recommends all physicians report e-prescribing via claims on at least 10 unique Medicare encounters by June 30, 2011 and report at least 25 unique Medicare encounters during the full 2011 year to qualify for the 2011 incentive (1 percent of Medicare Part B claims).
On Thursday, May 26, 2011, CMS issued a proposed rule that makes significant changes to the e-prescribing penalty program by adding more exemption categories so that physicians are not unfairly penalized for failing to meet the requirements under the 2012 e-prescribing penalty program. Physicians are still required to e-prescribe using a qualifying e-prescribing system and report the G8553 code on at least 10 Medicare Part B claims from January 1, 2011 through June 30, 2011 to avoid the 2012 e-prescribing penalty.
In order to avoid the 2012 e-prescribing penalty, physicians will have an opportunity to attest through an on-line web portal that they should be eligible for one of the following exemptions:
• Physician’s practice is located in a rural area without high speed internet access
• Physician’s practice is located in an area without sufficient available pharmacies for electronic prescribing
• Physician is registered to participate in the Medicare or Medicaid EHR Incentive Program and has adopted certified EHR technology
• Physician is unable to electronically prescribe due to local, State, or Federal law or Regulation (e.g., prescribes controlled substances)
• Physician infrequently prescribes (e.g., prescribe fewer than 10 prescriptions between January 1, 2011 –June 30, 2011)
• There are insufficient opportunities to report the e-prescribing measure due to program limitations
Physicians will have to apply for an exemption from the 2012 e-prescribing penalty via the web-portal tool by October 1, 2011.
The link to the e-prescribing proposed rule is up on the Statute Regulation section page of the E-Prescribing Incentive Program website. See the link below to view the proposed rule under “Related Links Outside of CMS”.
http://www.cms.gov/ERxIncentive/04_Statute_Regulations.asp#TopOfPage
The proposed rule will be published in the Federal Register on June 1, 2011. The comment period will close on July 25, 2011.
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