Medical societies and physician groups strongly oppose CMS's methodology to calculate 2012 penalties for failing to adopt electronic prescribing.
CMS detailed its plans for e-prescribing penalty programs in the proposed 2011 Medicare Physician Fee Schedule. Under the proposed rule, any provider who is eligible for the e-prescribing program needs to e-prescribe at least 10 times during the first six months of 2011. Financial penalties would be levied against any eligible provider who does not e-prescribe.
The medical associations believe CMS's penalty program is off. They say providers shouldn't be penalized one year for the previous year's performance.
And, they might be right. The enabling legislation, the Medicare Improvements for Patients and Physicians Act of 2008, for the program says the penalty will apply to "covered professional services furnished by an eligible professional during 2012 or any subsequent year, if the eligible professional is not a successful electronic prescriber for the reporting period for the year."
"Reviewing e-prescribing activity during the first six months of 2011 in order to assess penalties in 2012 and 2013 is an imbalanced approach," the AMA (pdf) says. "CMS has yet to produce the 2009 e-prescribing data to address whether there were any problems in e-prescribing reporting. Inflicting financial penalties in 2012 and 2013 based on 2011 e-prescribing activity without fully assessing the 2009 and 2010 program, including adoption and use rates, is unfair and unreasonable."
The Medical Group Management Association (MGMA) (pdf) says, "Using this logic, even if a practitioner satisfied the reporting requirement within the later part of 2011, they would be subject to 2012 penalties. We contend that EPs satisfying the minimum of 25 electronic prescriptions at any time during the reporting period (January 1, 2011 to December 31, 2011) should not be subject to penalties. We believe that the agency should review 2011 data after the February 28, 2012 deadline for reporting before assigning any penalties."