E-Prescribing Deadline Approaches

    E-Prescribing Deadline Approaches

    By Justin Vaughn, M.Div, CPC
    Vice President of Compliance


    For those of you who are deemed eligible by the government to participate in the CMS E-Prescribing (eRx) Incentive Program, June 30 is fast approaching.  That is the day by which you must:  (a) submit 10 Medicare claims involving eRx encounters (DOS: Jan 1 – Jun 30, 2013), (b) file a hardship exemption (see below), OR (c) register for the EHR Incentive Program (only if you have not previously achieved “meaningful use) and provide the EHR certification number during the registration process, in order to avoid the 2 % penalty adjustment in your total Medicare allowable in 2014.

    Remember that you are considered eligible to participate in the eRx program (and thus subject to the penalty) if at least 10% of your total Medicare allowable from Jan 1 – Jun 30, 2013 is derived from the office/outpatient E/M code sets (eg, 99201-99215).  If this applies to your personal practice, then you will need to look for a way to dodge the payment reduction.  In addition to the above remedies tied to the June 30 deadline, the following circumstances will also allow you to avoid the penalty:

    • You were a successful e-prescriber in 2012
    • You were not an MD, DO, NP or PA by June 30, 2013
    • You did not have at least 100 Medicare claims between Jan 1 – Jun 30, 2013 involving E/M codes 99201-99215
    • You do not have prescribing privileges and you had Medac report G8644 on at least one claim between Jan 1 – Jun 30, 2013 to so indicate

    If you are interested in determining if a possible hardship exemption (referenced above) might apply to you, and/or you would like to file for such an exemption, please visit the following website:  http://www.qualitynet.org/pqrs.

    The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author’s presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.