New Exemption Categories for 2012 eRx Penalty Finalized

On September 1, 2011 CMS finalized the changes to the E-Prescribing Incentive Program rule with new exemption categories for the 2012 eRx penalty. Eligible Professionals (MD, DO, or podiatrist, nurse practitioner or physician assistant) who were facing the prospect of being hit with a 1% penalty on their Medicare Part B Physician Fee Schedule (PFS) covered professional services for not successfully sending 10 e-prescriptions before June 30, 2011, now have two months to attest to four new exemptions, if applicable.

CMS will still use eRx activity from the first half of 2011 to determine if an EP met the 10 eRx requirement for the program. If they did not meet the 10 eRx minimum by June 30, 2011, they have until November 1, 2011 to claim one of the following exemptions:

New Exemptions:

  • He/She is an eligible professionals who registered to participate in the Medicare or Medicaid EHR Incentive Program and adopted certified EHR technology

  • He/She was unable to electronically prescribe due to local, state, or federal law or regulation

  • He/She had limited prescribing activity

  • He/She had insufficient opportunities to report the e-prescribing measure due to limitations of the measure's denominator

Old (but still valid) exemptions:

  • Eligible professional or group practice practices in rural areas with limited high speed internet access

  • Eligible professional or group practice practices in an area with limited available pharmacies for electronic prescribing

EPs were automatically exempt if in the first six months of the 2011 eRx reporting period (January 1-June 30, 2011), their Medicare allowed charges were not at least 10% of their total allowed charges; or they had fewer than 100 eligible office encounters.

 

If you are a current client and would like Medigistics to file the exemption on your behalf please contact your client service representative.

 

Providers can report their exemptions via a web-based tool, yet to be released by CMS. Providers must attest to the exemption by 11/1/11.  The CMS web-based tool for e-prescribing exemption process can be found here https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234