What happens if you missed June 30 e-Rx deadline? CMS responds!

by Grant Huang on Jul 7, 2011

DecisionHealth stock imageYou had until June 30, 2011 to e-prescribe at least 10 times and report G8553 to show CMS you were e-prescribing successfully. Now that June 30 has come and gone, many of your peers who didn't meet the requirement are betting that CMS will finalize its proposed rule adding four new hardship exemptions for e-prescribing, so they can avoid the 1% payment penalty in 2012.

But there is a plan B just in case the proposed hardship exemptions don't materialize. If you e-prescribe 25 times by Dec. 31, 2011 -- that is, by the end of this year -- you will qualify for a 1% payment bonus under the Medicare E-prescribing Incentive Program. The resulting 1% payment boost will offset the 1% payment penalty for missing the June 30 date, and you wind up with a 0% update where e-Rx is concerned.

Here is the official word from CMS on this subject:

"The 2011 incentive is 1.0% and the 2012 payment adjustment is 1.0%.  If the eligible professional did not report the G8553 code 10 times before June 30 for purposes of the 2012 payment adjustment, the eligible professional would be subject to the 1% payment adjustment.  However, the eligible professional can also meet the criteria for successful e-prescribing for the 2011 incentive (report G8553 25 times before December 31st) and get a 1.0% incentive, thereby negating the payment adjustment."

Key phrase: "Thereby negating the payment adjustment."

This tidbit will most likely ease the mind of any practice manager who had been planning to e-prescribe with a new electronic health records (EHR) system, but couldn't get that up and running in time to meet the June 30 date.

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