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.