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You may qualify for exemptions to avoid e-prescribing penalty
e-Reports, June 13, 2011
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The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that makes significant changes to the upcoming e-prescribing penalty by adding more exemption categories. These additional exemptions may prevent unfair penalties for failing to meet the requirements under the 2012 e-prescribing program.

The rule change comes following discussions on several occasions between AMA President Cecil Wilson, M.D., and CMS Administrator Don Berwick, M.D. Also, AMA staff has continually stressed with senior CMS officials the urgent need to modify the policy.

CMS responded May 26 and the proposed rule was published in the June 1, 2011, Federal Register. Physicians are still required to e-prescribe using a qualifying e-prescribing system and report the G8553 code on at least 10 Medicare Part B claims from Jan. 1 through June 30, 2011, to avoid the 2012 e-prescribing penalty.

However, you will have an opportunity to attest through an online Web portal that you should be eligible for one of these exemptions:

  • You practice in a rural area without high-speed Internet access.
  • You practice in an area with an insufficient number of pharmacies for electronic prescribing.
  • You registered to participate in the Medicare or Medicaid EHR Incentive Program and have adopted certified EHR technology.
  • You are unable to electronically prescribe due to local, state or federal law or regulation (e.g., you prescribe controlled substances).
  • You infrequently prescribe (e.g., fewer than 10 prescriptions between Jan. 1 and June 30, 2011).
  • You have insufficient opportunities to report the e-prescribing measure due to program limitations.

See the e-prescribing proposed rule on the Statute Regulation section page of the E-Prescribing Incentive Program website. Click on “Related Links Outside of CMS.”

The comment period will close July 25, 2011. You will need to apply for an exemption from the 2012 e-prescribing penalty via the Web portal tool by Oct. 1, 2011 – after the proposed rule is finalized.

The AMA will be reviewing the proposal in more detail.

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