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Home > News > New CMS Proposed Rule Would Modify E-Rx Incentive Program
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New CMS Proposed Rule Would Modify E-Rx Incentive Program

On Thursday, CMS issued a proposed rule that would let certain physicians claim additional exemptions from requirements in the electronic prescribing incentive program, American Medical News reports (Fiegl, American Medical News,5/26).  

Background

The Medicare Improvements for Patients and Providers Act established Medicare incentive payments for physicians who e-prescribe with approved software (iHealthBeat, 5/12). The e-prescribing program started paying out incentives in 2009, and Medicare providers who do not e-prescribe would face penalties beginning in 2012 (iHealthBeat, 3/18). Payment reductions would increase in following years (Norman, CQ HealthBeat, 5/26).   Existing CMS rules require eligible physicians to complete at least 10 drug orders using an e-prescribing system between Jan. 1 and June 30 to avoid a 1% decrease in Medicare payments next year. The rules provide exemptions for rural physicians with limited Internet access or for physicians located where few pharmacies accept e-prescriptions. Physicians have to claim such a hardship waiver by June 30.  

Changes Under Proposed Rule

Under the proposed rule, the deadline for physicians to claim exemptions would be extended from June 30 to Oct. 1 (American Medical News, 5/26). The proposed rule also aims to let health care providers who have not adopted e-prescribing systems claim additional exemptions to avoid potential Medicare pay cuts (CQ HealthBeat, 5/26).   The possible reasons for an exemption are:
  • Having limited prescribing activity during the six-month time frame;
  • Living in an area where regulations prevent e-prescribing;
  • E-prescribing only for types of patient visits that do not count toward the 10-order requirement; and
  • Delaying the purchase of an e-prescribing system because of plans to participate in the incentive program for the meaningful use of electronic health records.
  Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments (American Medical News, 5/26).   In addition, the proposed rule would expand the definition of a qualified e-prescribing system. Under the rule, EHRs certified to meet meaningful use rules would be deemed to qualify for the e-prescribing incentive program (Goedert, Health Data Management, 5/27).   CMS will publish the proposed rule in the Federal Register on June 1 and will accept public comments on the rule until July 25 (CMS release, 5/26). More info….
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