You and your peers may be able avoid the 1% e-Prescribing (e-Rx) Medicare payment penalty if you qualify for one of CMS’s new proposed hardship exemptions outlined in its May 26 proposed rule.
Remember: As it stands, in order to avoid the e-Rx penalty effective Jan. 1, 2012, eligible providers must e-prescribe to 10 unique patients by June 30 and a total of 25 patients by year’s end to qualify for the bonus. The penalty jumps to 1.5% in 2013.
The proposed rule gives providers a more flexible timeline and more options to claim a hardship exemption for not being able to meet the e-Rx requirement by June 30.
NOTE: Providers currently can only claim hardship from two exemption categories to avoid the penalty: (1)The physician or practice is in a rural area with limited Internet access; and/or (2) is in an area with limited available e-Rx compatible pharmacies.
In response to the push from physician advocacy groups--including the American Medical Association (AMA) that wrote a letter to CMS in April requesting changes to the e-Rx regulation--CMS proposes adding four new categories:
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Practices that plan to participate in the Electronic Health Records (EHR) Incentive program in 2011 but delayed buying an e-Rx system. (Example: The practice wanted to rely on the e-Rx technology of an EHR system, but the vendor software is not yet compliant.)
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Providers who cannot e-prescribe due to state or federal law restrictions (Example: Physicians who largely prescribe narcotics, which are restricted from being electronically transmitted in some areas.)
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Eligible professionals who do not prescribe often.
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Certain physicians who prescribe frequently but only for ineligible types of visits. (Example: Surgeons.)
Physicians qualifying under these exemptions would have until Oct. 1, or five business days after the rule is finalized, to claim one of the proposed hardship exemptions, CMS writes in the proposed rule.
NOTE: However, physicians who plan to claim under the current hardship exemptions have to do so by June 30.
CMS also proposed establishing a web-based tool that would allow providers to claim exemptions and is accepting public comments on the proposed exemptions as well as the online system until July 25.
It’s not clear when CMS would finalize the proposal. You can submit comments on the proposed rule electronically at www.regulations.gov or you can mail them to “Attention: CMS-3248-P, P.O. Box 8013, Baltimore, MD 21244.”