CMS may exempt individual eligible professionals and group practices participating in the eRx GPRO from the 2013 payment adjustment if it is determined that compliance with the requirement for being a successful electronic prescriber would result in a significant hardship.
Hardship Exemption Circumstances and Codes:
Inability to electronically prescribe due to state, or federal law, or local law or regulation;
The eligible professional prescribes fewer than 100 prescriptions during a 6–month payment adjustment reporting period;
The eligible professional practices in a rural area without sufficient high-speed Internet access (G8642); and
The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing (G8643).
Submitting a Hardship Request
CMS established the Quality Reporting Communication Support Page at http://www.qualitynet.org/pqrs for eligible professionals to submit hardship requests, including those associated with a G-code.
For more information detailing how to navigate the Quality Reporting Communication Support Page, please reference the following documents:
“Quality Reporting Communication Support Page User Guide” posted on the QualityNet website at https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234 on the Internet; and
“Tips for Using the Quality Reporting Communication Support Page” at http://www.cms.gov/ERxIncentive/20_Payment_Adjustment_Information.asp on the CMS website.
A hardship G-code may also be submitted at least once on a claim during the 6-month 2013 eRx payment adjustment reporting period, if applicable.
The hardship G-code must be submitted on a claim with a billable Medicare Part B service.
The hardship G-code does not need to be submitted on a claim that contains eRx measure denominator codes