CMS Finalizes Changes to Medicare E-Rx Incentive Program for Calendar Year 2011

Today CMS finalized changes to the Medicare E-Rx Incentive Program for Calendar Year 2011. In response to public comments raising concerns that the Medicare E-Rx Incentive program was inconsistent with the Medicare EHR Incentive Program, and that there was a need for additional significant hardship exemption categories, CMS is making the following changes:

• modifying the 2011 electronic prescribing measure to say that a qualified electronic prescribing system for the purpose of the Medicare E-Rx Incentive Program includes certified EHR technology under the Medicare and Medicaid EHR Incentive Programs.
• adding four additional significant hardship exemptions that will make eligible professionals (EPs) exempt from the 2012 payment adjustment:
  EPs who register to participate in the Medicare or Medicaid EHR Incentive Program and adopt certified EHR technology (you are participating in the EHR incentive program);
  EPs who are unable to electronically prescribe due to local, state, or federal law or regulation (i.e., prescribe a lot of narcotics);
  EPs who have limited prescribing activity (i.e., the physician wrote fewer than 10 prescriptions in the first half of 2011); and
  EPs who have insufficient opportunities to report the e-prescribing measure due to limitations of the measure’s denominator (e.g., prescriptions provided after surgery that are not associated with a billable office visit).

The two hardship exemptions already available to professionals are:

• EP or group practice practices in rural areas with limited high speed internet access; and
• EP or group practice practices in an area with limited available pharmacies for electronic prescribing.

CMS is also extending the deadline for requesting significant hardship exemptions to the 2012 E-Rx payment adjustment to November 1, 2011; and providers will be able to do so via a web-based tool for eligible professionals or via a mailed letter for group practices that are participating in the E-Rx group practice reporting option for 2011.

The AAO believes that CMS will receive a large volume of requests for exemption, and that it may not be possible to review all exemption requests in a timely manner. They recommend that, if you plan to file for an exemption, do so as soon as possible rather than wait until close to the deadline.

Instructions on how to request a hardship via the web-based tool will be available on the E-Rx Incentive Program website at http://www.cms.gov/ERXincentive/.

The final rule can be found at http://www.ofr.gov/OFRUpload/OFRData/2011-22629_PI.pdf