Medicare Electronic Prescribing

Physicians Without eRx Exemption Face Penalty

January 09, 2013 01:15 pm News Staff

Medicare participating physicians who did not meet the requirements for Medicare's Electronic Prescribing (eRx) Incentive Program in 2012 face a 1.5 percent Medicare pay cut in 2013. CMS began notifying eligible professionals of their penalty status in December via the U.S. Postal Service.

[Signage-Pay Cuts Ahead]

Physicians who disagree with CMS' determination of a penalty assessment may submit an informal review request by e-mail. CMS will accept review requests through Feb. 28.

All requests must include the individual's National Provider Identifier number; contact information, including an e-mail address, telephone number and mailing address; and justification as to why an informal review is appropriate.

Physicians should note that CMS recently reopened its quality reporting communication support page( to allow physicians additional time to request hardship exemptions for 2012 and thereby avoid the 2013 e-prescribing penalty. The page will be available to physicians until Jan. 31, 2013.

Several hardship exemptions are available to physicians unable to participate in the program, including those who

  • practice in rural areas with little or no access to high-speed Internet;
  • work in locales where a limited number of pharmacies have implemented e-prescribing;
  • write less than 100 prescriptions during a six-month period of time;
  • lack sufficient opportunities to use the required CPT codes;
  • cannot e-prescribe because of local, state or federal regulations; or
  • demonstrate intent to participate in the separate but related Medicare Electronic Health Record Incentive Program.

Physicians who are granted hardship exemptions will not be exposed to penalties for nonparticipation. Eligible professionals who do not participate in the Medicare eRx program in 2013 face an increased Medicare penalty consisting of a 2 percent reduction in pay in 2014.

Additional Resource
CMS Spotlight: Electronic Prescribing Incentive Program(