This blog is the third in a series of blogs related to the bureaucracy of the Medicare eRx program.

On February 24, 2010, in our blog titled, The Electronic Prescribing (eRx) Incentive Program — A lot of stick, not too much carrot, we discussed how the 2011 e-Prescribing (eRx) program was not properly aligned with the more encompassing Meaningful Use incentive program. The conclusion at the time was that users of certified EHR technology were unfairly required to report the Medicare e-Prescribing G-codes on at least 10 claims between January and June of this year (2011), in addition to reporting the eRx measure when attesting to Meaningful Use. At the time, our medical team responded to this requirement by providing the codes in our procedure coding section of the SOAP note, creating a reminder for our users, and making it simple for them to express these codes on at least 10 claims.

On July 12, 2011, in our blog titled, The eRx Incentive Program an Update – A welcome dose of Medicare common sense, we presented the good news that Medicare was planning on amending the eRx rule, and that certain waivers or exceptions would be created that would impact users that did not enter the required G-codes on 10 claims in the first half of 2011.

Now, Medicare has provided more information on who qualifies and how to claim an exception from the 2012 eRx penalty.

In the interest of saving our readers time – if you billed the appropriate G-codes in the first half of this year feel free to stop reading, you will not be penalized in 2012, and for 2011 you have already met the Medicare eRx requirement.

If you did not bill the G-codes on 10 claims in the first half of this year – Medicare has provided more clarity on how to claim exceptions to avoid the 1% penalty next year in a recent blog titled, Greater Flexibility in e-Prescribing Means Greater Success.

In this blog, the authors confirm that a qualified electronic prescribing system for the purpose of the Medicare eRx Incentive Program includes certified EHR technology like MediTouch EHR®. In addition, the following new exceptions to the 2012 penalty were added:

  1. Eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Program and adopt certified EHR technology
  2. Eligible professionals who are unable to electronically prescribe due to local, state, or federal law or regulation
  3. Eligible professionals who have limited prescribing activity
  4. Eligible professionals who have insufficient opportunities to report the e-prescribing measure due to limitations of the measure’s denominator

These four new exceptions supplement the existing two exceptions:

  1. Eligible professionals or group practices in rural areas with limited high speed internet access
  2. Eligible professionals or group practices in an area with limited available pharmacies for electronic prescribing

The most important new exception for MediTouch® users is the new exception for doctors that register to participate in the Medicare or Medicaid EHR Incentive Program and adopt certified EHR technology.

Medicare is extending the deadline for requesting exemptions to November 1, 2011, and they plan on allowing providers to report exemptions to the 2012 eRx payment adjustment via a Web-based tool.

e-Prescribing Penalty 2012

Medicare has not yet posted that Web-based exception tool, and we still do not know specifically what providers will be asked to attest to when completing the Web form. We will let our readers know when the tool is posted and the final details of claiming exceptions are clarified.

There is not much of a window for providers to claim an exception, since the deadline is less than one month away. We do know this – if you do not want to be penalized in 2012, and you have not already met the 2011 requirement, the clock is ticking. We suggest you adopt MediTouch EHR®, and that you register action for the EHR incentive program on the Medicare Website without delay!