e-Prescribing Program Penalties begin January 1, 2013

In 2008, the Medicare Improvements for Patients and Providers Act (MIPPA) established a five-year incentive program that began in 2009, to promote the adoption and use of electronic transmission of prescriptions (e-Prescribing). The Act also outlined a penalty phase from 2012 to 2014 for those who do not e-Prescribe. CMS released the final 2013 penalty regulations last November. Based on the 2013 fee schedule amounts, a 1.5% payment reduction will be imposed on those that do not participate or timely file for an exemption.

To avoid the 2013 payment adjustment, eligible professionals had to have been a successful electronic prescriber in 2011 or will need to report the G8553 code through claims for at least 10 billable Medicare Part B PFS services provided January 1, 2012 through June 30, 2012. For more details visit the CMS Educational Resources on e-Prescribing.

If you meet one or more of the exemption categories, you may apply for a hardship exemption. Providers must apply on-line through the CMS hardship exemption request page by June 30, 2012 to avoid January 1, 2013 penalties. No mail, email, or fax applications will be accepted.

There is no formal appeal or review process for the program but the QualityNet Help Desk is available for questions and concerns. All communication will be taken and handled on a case-by-case basis. All reviews for hardship exemption requests have been completed by CMS. If you have not received a formal notice from CMS regarding the final status of your exemption request or you feel you are receiving a 2012 e-prescribing adjustment in error, contact the Quality Net Help Desk. The Quality Net Help Desk can be reached by phone at 1-866-288-8912 or by email at Qnetsupport@sdps.org.

CMS EHR Incentive Program note:
Eligible Professionals that choose to participate in the Medicare EHR Incentive Program cannot participate in the Medicare e-Prescribing Program simultaneously in a same program year. Eligible Professionals participating in the Medicaid EHR Incentive program can participate in both the EHR and the Medicare e-Prescribing Program simultaneously in the same program year.