Penalty for unsuccessful e-prescribers coming in 2014

Were you a successful electronic prescriber under either the 2012 or 2013 Medicare Electronic Prescribing (eRx) Incentive Program? If so, congratulations! If not, expect slightly smaller Medicare payments in 2014.

Eligible professionals and group practices (who self-nominated for the 2012 and/or 2013 eRx group practice reporting option) who didn't successfully complete the incentive programs will receive a 2 percent penalty next year. That means they'll receive only 98 percent of the Medicare Part B physician fee schedule allowed charges they would otherwise have received for services provided from Jan. 1–Dec. 31, 2014.

If you do get notified by the Centers for Medicare & Medicaid Services (CMS) that your payments are being cut, you can get a second opinion by requesting an informal review. Complete instructions on how to request an informal review are available in the 2014 eRx Payment Adjustment Informal Review Made Simple educational document on the CMS web site. You should email your eRx informal review request to eRxInformalReview@cms.hhs.gov no later than February 28, 2014.  

For all other questions related to the eRx Incentive Program, CMS asks that you contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or via qnetsupport@sdps.org. They are available Monday through Friday from 7 a.m.–7 p.m. CST.

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