Deadline to Request Hardship Exemptions From Medicare's 2011 e-Prescribing Incentive Program Extended

September 07, 2011 06:35 pm Sheri Porter

Family physicians planning to submit requests for hardship exemptions from the 2011 Medicare electronic prescribing, or e-prescribing, incentive program have an extra month to do so, according to Steven Waldren, M.D., director of the AAFP's Center for Health IT, in reaction to the Aug. 31 release of CMS' final rule(www.gpo.gov) on the program.

Physicians now have until Nov. 1 to attest for hardship exemptions; that's a one-month extension from the original deadline.

That's good news, said Waldren, who added that the Academy was generally pleased that CMS listened to concerns from the AAFP and other physician organizations regarding the proposed rule.

However, Waldren was disappointed to learn that physicians who don't successfully e-prescribe in 2011 still face a penalty in 2012. "Because of deadlines imposed by CMS, physicians have their hands full navigating multiple government regulations that all hinge on the successful implementation of an electronic health record system (EHR) by 2012," he told AAFP News Now.

In addition to interpreting e-prescribing rules, physicians are scrambling to meet EHR meaningful use requirements and prepare for conversion to the ICD-10 code set for outpatient diagnosis coding in 2013, "even though CMS has yet to finalize some of those regulations," said Waldren.

Story Highlights

  • CMS released the final rule on the 2011 Medicare e-prescribing incentive program.
  • Physicians now have until Nov. 1 to attest for hardship exemptions, which reflects a one-month extension from the original deadline.
  • Physicians who don't successfully e-prescribe in 2011 still face a penalty in 2012.

CMS spelled out other changes in its Medicare e-prescribing, or Medicare eRX, incentive program in an agency fact sheet(www.cms.gov) also released on Aug. 31. According to that document, CMS

  • adjusted language in the final rule to reflect that a "qualified" e-prescribing system for the purposes of the Medicare eRx incentive program includes "certified" EHR technology necessary for physicians to participate in the Medicare or Medicaid EHR incentive programs, and
  • added verbiage that allows physicians to use a Web-based tool when requesting a hardship exemption -- group practices can do so via a written letter.

Also finalized in the rule were additional hardship categories previously proposed and discussed that offer hardship exemptions to physicians who

  • are unable to e-prescribe because of local, state or federal regulations;
  • experience limited prescribing activity; or
  • have insufficient opportunity in their practice setting to use the required CPT codes.

The e-prescribing rule originally offered hardship exemptions for physicians who practice in rural areas with limited high-speed Internet access and physicians working in areas where few pharmacies have implemented e-prescribing.

An Aug. 31 message(blog.cms.gov) posted on the official CMS blog site explained the revisions made in the final rule: "We've made several changes to the newly released final rule for the 2011 electronic prescribing (e-Rx) incentive program that will encourage more doctors and other health care professionals to adopt this technology and give them the added flexibility to help them succeed," said CMS Chief Medical Officer Patrick Conway, M.D.

"Changes in the final rule will help doctors and other health care professionals in their efforts to become successful e-prescribers, ultimately leading to fewer errors and better care for patients," Conway added.


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