CMS Releases Final Regulation on the 2012 Medicare E-Prescribing Penalty Program; Outlines Exemption Details September 1, 2011 AMA, Medicare, News, Payment 2012 Medicare e-prescribing penalty, CMS, E-Prescribing, Medicare 2 Centers for Medicare and Medicaid (CMS) released the final regulation on the 2012 Medicare e-prescribing penalty program yesterday. The final rule includes recommendations from AMA, and provides more flexibility under the exemption categories so that more physicians can be eligible for an exemption to avoid the 2012 e-prescribing penalty. Physicians can also apply for more than one exemption category if a combination of categories apply to their particular hardship. In addition, CMS extended the deadline to apply for an exemption to November 1, 2011. Details of the final 2012 Medicare e-prescribing penalty program are listed below. Final exemption hardship categories for eligible physicians to avoid the 2012 Medicare e-prescribing penalty are as follows: The physician’s practice is located in a rural area without high speed internet access. The physician’s practice is located in an area without sufficient available pharmacies for e-prescribing (CMS added more examples including natural disaster caused disruption of e-prescriptions between physician office and pharmacies). The physician is registered to participate in the Medicare or Medicaid EHR Incentive Program and has adopted Certified EHR Technology by October 1, 2011, and prior to the time the physician requests an exemption. Inability to electronically prescribe due to local, state, for federal law or regulations (CMS clarifies that physicians who mainly prescribe narcotics but due to certain limitations cannot submit these prescriptions electronically can apply for this exemption category). Limited prescribing activity (physicians who do not prescribe on a regular basis may apply for this exemption). Insufficient opportunities to report the e-prescribing measure due to limitations of the measure’s denominator (physicians who do not e-prescribe on the service date can apply for this exemption). Although physicians are required to apply for at least one exemption category, CMS will allow physicians to apply for more than one exemption category if a combination of the categories apply to their particular hardship. individual Physicians Individual physicians must apply online via a web-based tool (cannot submit request via mail, email, or fax) for an exemption(s) by no later than November 1, 2011, in order to avoid the 2012 Medicare e-prescribing penalty. Physicians are required to include the following information in their exemption request: Identifying information such as TIN, NPI, name, mailing address, and email of all affected eligible professionals. The significant hardship exemption category(ies) that apply. A justification statement describing how compliance with the requirement for being a successful e-prescriber for the 2012 e-prescribing penalty program during the reporting period resulted in a significant hardship to the eligible physician. An attestation of the accuracy of the information provided. Instructions on how to access the web-based tool and request for exemption(s) will be available on CMS’ E-Prescribing Incentive Program website at www.cms.gov/ERxIncentive/. Group Practices Group practices already participating in the 2011 e-prescribing group practice reporting option that wish to submit an exemption request must submit their request via a mailed letter (cannot submit online) containing all of the necessary information for the exemption request. The letter must be postmarked no later than November 1, 2011. More information on how group practices may request for an exemption(s) via mail, such as the mailing address for submitting the request, will be available at www.cms.gov/ERxIncentive/. Upon the effective date of the final rule, physicians will be allowed to use Certified EHR technology that complies with the Part D standards for electronic transmission of prescriptions for the remainder of the 2011 Medicare e-prescribing incentive program reporting period (through December 31, 2011) and to avoid the 2013 e-prescribing penalty (e.g., e-prescribe and report the G8553 code at least 10 times on applicable Medicare Part B claims by June 30, 2012). Comments are closed.
