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How to avoid 2012 E-prescription penalties?


The eligible professional becomes a successful electronic prescriber for purposes of the 2012 payment adjustment by reporting the electronic prescribing measure via claims for at least 10 unique electronic prescribing events for patients in the denominator of the measure between January 1, 2011 and June 30, 2011. For eligible professionals who aren’t successful electronic prescribers and to avoid penalty charges CMS is adding four additional significant hardship exemptions that will make professionals exempt from the 2012 payment adjustment:

1. Eligible professionals who register to participate in the Medicare or Medicaid EHR incentive program and adopt certified EHR technology;

2. Eligible professionals who are unable to electronically prescribe due to local, state, or federal law or regulation;

3. Eligible professionals who have limited prescribing activity; and

4. Eligible professionals who have insufficient opportunities to report the e-prescribing measure due to limitations of the measure’s denominator.

The two hardship exemptions already available to professionals are

1. Eligible professional or group practice practices in rural areas with limited high speed internet access HCPCS G8642; and

2. Eligible professional or group practice practices in an area with limited available pharmacies for electronic prescribing HCPCS G8643.

CMS is also modifying the 2011 electronic prescribing measure to say that a qualified electronic prescribing system for the purpose of the Medicare eRx Incentive Program includes certified EHR technology under the Medicare and Medicaid EHR Incentive Programs.

How do I submit a 2012 eRx Payment Adjustment Significant Hardship Exemption Request?

CMS is no longer accepting significant hardship exemption requests for the 2012 eRx payment adjustment via claims. However, they are accepting hardship exemption requests through other avenues. Below are the steps you need to take to request a significant hardship exemption. Please note that the action required is different depending on whether you are an individual eligible professional or a group practice.

If eligible professional participating as an individual Eligible Professional:

Use the new CMS provider webpage, called the Quality Reporting Communication Support Page, to enter the request and supporting rationale. The request must be submitted by November 1, 2011.

A Quality Communications Support Page User Manual is also available to answer questions eligible professionals may have.

If eligible professional participating using the Group Practice Reporting Option (GPRO):

Group practices selected for and participating in the 2011 GPRO I or II reporting option wishing to submit a 2012 exemption request should submit a letter to:

Significant Hardship Exemptions,
Centers for Medicare & Medicaid Services,
Office of Clinical Standards and Quality, Quality Measurement and Health Assessment Group,
7500 Security Boulevard, Mail Stop S3-02-01, Baltimore, MD 21244-1850.

*This letter must be postmarked no later than November 1, 2011.*

References:




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