Time Is Running Out to Avoid Medicare ePrescribing Penalty 

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The Medicare ePrescribing program was established in 2009 to encourage providers to adopt electronic prescribing systems. Beginning in 2012, there is a legislative mandate to assess payment adjustments for those providers who fail to successfully report on the ePrescribing measure.

Providers have until June 30 to avoid the 1 percent penalty that will be assessed on Medicare charges in 2012.  Between January 1 and June 30 of 2011, providers must report the ePrescribing measure on at least 10 unique encounters with CPT codes included in the ePrescribing measure specifications.

There are circumstanced under which providers can avoid the negative payment adjustment:

• An eligible professional is not a physician, nurse practitioner or physician assistant as of June 30, 2011;
• The eligible professional does not have prescribing privileges and reports G-code G8644 at least once before June 30, 2011;
• An eligible physician for whom office visits and other services listed in the ePrescribing measure specifications represent less than 10 percent of their allowed Medicare charges over the 6 month reporting period; or
• An eligible physician who has less than 100 claims for patient services containing visit and service codes that fall within the ePrescribing measure specifications for the 6 month reporting period.

CMS is proposing to add more hardship exemptions to the program going forward, but they have not yet been finalized and will not apply until that time. AASLD will notify you if and when this occurs. They are as follows:

• The physician is registered to participate in the Medicare of Medicaid EHR Incentive Program and has adopted certified EHR technology.
• The physician is unable to electronically prescribe because of local, State or Federal law or regulation.
• The physician infrequently prescribes (less than 10 prescriptions between January 1- June 30 of 2011).
• There are not enough opportunities to report the ePrescribing measure because of program limitations.

It should also be noted that to avoid the negative payment adjustment of 1.5 percent in 2013 providers must report the ePrescribing measure 25 times between January 1 and December 31 of 2011.