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Potential CMS Extension for E-Prescription Exemptions
By Jacqueline Thelian, CPC, CPC-I

Eligible physicians were required to complete a minimum of 10 e-prescriptions via an e-prescribing system between January 1 and June 30 or face a 1% Medicare payment reduction in 2012.

The May 26 Federal Register released a Centers for Medicare & Medicaid Services (CMS) proposed rule allowing a second chance for physicians to avoid the penalty by claiming a hardship exemption. The proposed rule includes additional opportunities to claim a hardship exemption and extends the deadline from June 30 to October 1.

Under the proposed rule, physicians who do not meet the e-prescribing requirements have the opportunity to claim one of the following hardship exemptions by October 1 through a special CMS website:

• The physician had limited prescribing activity during the six-month time frame.

• The physician has delayed purchasing an e-prescribing system because he or she intends to participate in Medicare’s EMR incentive program for 2011.

• The physician lives in an area where regulations prevent e-prescribing, such as those prohibiting paperless orders for narcotics.

• The physician e-prescribes but only for types of visits that don’t count toward the 10-order minimum.

Currently, the following two exemptions have been finalized:

• G8642: The eligible professional practices in a rural area without sufficient high-speed Internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

• G8643: The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

To date, the CMS website has not been developed. Additionally, the CMS has not indicated how hardship requests are to be submitted should the website not be available.

To learn more about the e-prescribing program, visit www.cms.gov/ERxIncentive/04_Statute_Regulations.asp.

— Jacqueline Thelian CPC, CPC-I, is a healthcare consultant, certified professional coder, auditor, subject matter expert, educator, and author with more than 20 years of experience in medical coding and business management. She has taught extensively in academic medical centers, The Chubb Institute, hospitals, and private physician practices and is a certified instructor for the PMCC — Coding Certification Prep Course.