Medicare E Prescribing Alert!

To Avoid the CMS Medicare E-Prescribing Penalty in 2013,
you must act by October 15, 2012

E prescribing is a way to increase patient safety and reduce medical errors. The Institute of Medicine (IOM) estimates that 100,000 Americans die each year from preventable medical errors in hospitals.

E Prescribing - Will You Avoid Medicare E Prescribing Penalty Payment Adjustments?

The Medicare eRx incentive program was established by the Medicare Information Patient Provider Act (MIPPA).

Under MIPPA, Medicare health care providers could receive incentive payments for e prescribing in the 5 year period ending in 2013. But there are also penalties for those who fail to meet the CMS Medicare e prescribing requirements

Which Medicare health care providers are subject to e prescribing payment adjustments?

  • Doctor of Medicine (MD)
  • Doctor of Osteopathy (DO)
  • Doctor of Podiatric Medicine (DPM)
  • Physician Assistant (PA)
  • Nurse Practitioner (NP)

How do you avoid the 2013 E Prescribing Penalty?

The article:

E Prescribing: Do You Qualify For Medicare E Prescribing Incentive Money?

lists the detailed requirements for Medicare Physicians to get e prescribing incentive payments. In summary:

  • 25 unique e prescribing events
  • G8553 on claims for 10 billable Medical Part B services
  • 10% total Medicare Part B with appropriate cpt codes.

If your medical practice met the above criteria, you’re all set. You qualify for the 2012 1% electronic prescribing incentive and you avoid the 1.5% e prescribing penalty in 2013.

If you missed that you may be able to apply for a hardship exemption by October 15, 2012

What if you didn’t successfully e-Prescribe by June 30, 2012?

If you didn’t meet the e prescribing deadlines, then you will be penalized in the form of Medicare reimbursement payment adjustments – UNLESS you qualify for one of hardship exemption options.

An eligible professional (EP) can make a significant hardship exemption request until October 15, 2012. There are three hardship options.

Exemption 1: Eligible Professional (EP) Achieved Meaningful Use by June

Meaningful use of the HITECH Act electronic medical record systems can be used as E Prescribing Hardship Exemption.

You must be an Medicare physician that has not previously adopted ONC Certified EHR technology or has not received an incentive payment under the Medicare or Medicaid EHR Incentive Program

If you met the electronic health record / electronic medical records meaningful use stage 1 criteria for a 90 day period by June 30, 2012, then you are an e Prescribing success! You avoid the e-prescribing penalties for 2013.

Anyone who started using their certified electronic health records (EHR) / EMR software after April to get the meaningful use incentive would not qualify for this first hardship exemption

Exemption 2: EP Demonstrates Intent to Participate in EHR Incentive Program

This exemption is for an eligible professional “who attempt to participate in the Medicare and Medicaid EHR Incentive Program from January 2, 2012, through October 15, 2012, or the effective date of the final MPFS rule”. http://www.mwe.com/CMS-Proposes-New-Hardship-Exemptions-to-Medicare-eRx-Penalties-07-24-2012/

The EP must
a) be registered to participate in the EHR Incentive Program
and
b) have adopted Certified EHR / EMR Technology prior to application of the respective payment penalties.

For your EMR software to meet the EHR adoption criteria, you must have completed

  • installation
  • configuration
  • customization
  • training
  • workflow redesign and
  • establishment of health information exchange / HIE
    (e.g. electronic prescribing) connectivity.

Exemption 3: Special Case Hardships

CMS will grant these exemptions on a case by case basis, if:

  • The EP or group practice practices in a rural area with limited high-speed internet access.
  • The EP or group practice practices in an area with limited available pharmacies for electronic prescribing.
  • The EP or group practice is unable to electronically prescribe due to a local, state or federal law or regulation.
  • The EP or group practice generates fewer than 100 prescriptions during a six-month reporting period.

The benefits of e prescribing for prescription drugs are many. Eliminating an adverse drug reaction, medication management, and providing the ability to check for drug interaction increases patient safety. This makes e prescribing a national priority.

E prescribing also make you money with CMS Medicare incentive payments and save you money when you avoid the e prescribing penalties.

Got questions?
about the HITECH Act, Electronic Medical Records or the
Centers for Medicare Medicaid Services (CMS)
EHR incentive program
?

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