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Tuesday Apr 23, 2013

A limited time opportunity on eRx penalties

Time is running out for physicians to avoid having their Medicare Part B fees cut next year under a federal initiative that encourages electronic prescribing.

The Centers for Medicare & Medicaid Services (CMS) has given practices until June 30, 2013, to show that they have met e-prescribing (eRx) requirements during the first six months of this year (or during the 12-month eRx reporting period of Jan. 1, 2012-Dec. 31, 2012) or to request a hardship exemption from the requirements to avoid the 2014 penalty. (CMS calls it a "payment adjustment.")

Practices can also avoid the 2014 penalty if they do one of the following by June 30, 2013:

•    Register to participate in the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program and adopt certified EHR technology; or

•    Attest achievement of meaningful use under the EHR Incentive Program during either the 12-month eRx reporting period (Jan. 1, 2012-Dec. 31, 2012) or the six-month eRx reporting period (Jan. 1, 2013-June 30, 2013).

If you are currently subject to the eRx payment adjustment or have been in the past, you are not alone. CMS reports(www.cms.gov) that 135,931 eligible professionals were subject to the 2012 eRx payment adjustment because they did not qualify for an exemption, meet exclusion criteria for the adjustment, or comply with eRx reporting requirements in the first half of 2011.

The payment adjustment in 2014 will be 2 percent, which means if you are subject to the adjustment, you will only receive 98 percent of your Medicare Part B physician fee schedule amount for covered professional services, assuming you are not subject to any other payment adjustments under Medicare.

On March 1, CMS re-opened the Quality Reporting Communication Support Page(www.qualitynet.org) to allow individual eligible professionals and group practices the opportunity to request a significant hardship exemption for the 2014 eRx payment adjustment. As noted, hardship exemption requests will be accepted through June 30, 2013. After that, you're out of luck. Also, please note this applies only to hardship exemption requests for the 2014 eRx payment adjustment. The reporting period to avoid the 2013 eRx payment adjustment, or to submit hardship exemption requests, has ended.

The following resources are available to assist individual eligible professionals and group practices in submitting their request for a hardship exemption:

Quality Reporting Communication Support Page User Guide(www.qualitynet.org)

Tips for Using the Quality Reporting Communication Support Page(www.cms.gov)

For additional information on the 2014 eRx payment adjustment, including who is subject to the payment adjustment and how to avoid it, please review the 2014 eRx Payment Adjustment Fact Sheet(www.cms.gov).

– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians

Posted at 11:50AM Apr 23, 2013 by David Twiddy

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