January 11, 2013
Area(s) of Interest: Drug Prescribing/Dispensing Health Information Technology
Physicians who were unable to file for a Medicare e-prescribing hardship exemption by the original deadline of June 30, 2012, have until Jan. 31, 2013, to avoid the 2013 payment penalty.
Medicare’s e-prescribing program provides payment incentives for physicians who e-prescribe and payment penalties for physicians who do not. In 2013, Medicare will impose a 1.5 percent payment reduction penalty on all Medicare allowed charges for eligible professionals who were not successful e-prescribers for 2011, did not report e-prescribing activity using measure code G8553 for at least 10 eligible outpatient visits via claims submission in the first six months of 2012, or did not request an exemption. The penalty increases to 2 percent in 2014.
Physicians may request a waiver of the 2013 penalty under any of the following categories:
- The physician is unable to e-prescribe as a result of local, state or federal law or regulation.
- The physician wrote fewer than 100 prescriptions during the period of Jan. 1–June 30, 2012.
- The physician practices in a rural area that doesn't have sufficient high-speed Internet access.
The physician practices in an area that doesn't have enough pharmacies that can do e-prescribing.
To request an exemption, visit the Centers for Medicare & Medicaid Services (CMS) Quality Reporting Communication Support Page at http://cal.md/erx-exemption.
CMS has also added two automatic exemption categories for those participating in Medicare’s electronic health record meaningful use program. The two new exemption categories include physicians who:
- Demonstrated "meaningful use" of an EHR system during the previous e-prescribing period, which ran from Jan. 1, 2011, to June 30, 2012; or
- Register to participate in the Medicare or Medicaid EHR incentive programs by Jan. 31, 2013. (The EHR Certification Number must be in the EHR Certification Registration ID field to qualify.)
The two new exemptions are automatic and physicians do not need to apply for a hardship exemption if they meet one of the two new criteria. CMS will automatically exempt these physicians from the 2013 payment penalty.
If you have questions or needs assistance submitting a hardship exemption request, please contact the QualityNet Help Desk at (866) 288-8912 or firstname.lastname@example.org. They are available Monday through Friday from 7 a.m. to 7 p.m. CST.