New Exemptions for e-Prescribing

The Center for Medicare & Medicaid Services (CMS) issued a proposed rule that makes significant changes to the e-prescribing penalty program by adding more exemptions categories so that physicians are not unfairly penalized.

The previous rules required physicians in individual practices to submit at least 10 Medicare Part B claims with the electronic measure code eRx G8553 and an eligible encounter code by June 30, 2011, or face a claims payment reduction of 1 percent in 2012.

Physicians are still required to e-prescribe using a qualifying system and electronic measure code; but, through an online web portal, will have an opportunity to show eligibility 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 electronic health record incentive (EHR) 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, and June 30, 2011); and
  • 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 online web-portal by October 1, 2011.

The proposed rule can be viewed at the Office of the Federal Register website. It will be published in the Federal Register on June 1, 2011. The comment period closes July 25, 2011.

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