According to a recent blog post written by Patrick Conway, M.D., MSc, Centers for Medicare and Medicated Services (CMS) Chief Medical Officer and Director of the Office of Clinical Standards & Quality, “electronic prescribing plays a vital role in improving patient care and helping make our health care system more efficient.”
Dr. Conway explained that, “with electronic prescribing, providers can better manage patient prescriptions, reducing drug interactions or other preventable prescription errors.”
His post came in response to CMS recently issuing a final rule for the 2011 Electronic Prescribing (eRx) Incentive Program that will encourage more doctors and other health care professionals to adopt this technology and give them the added flexibility to help them succeed.
In particular, he noted that the changes will better recognize those circumstances when the ability of professionals to meet the eRx requirements is limited and when the requirements clearly pose a significant hardship. Specifically, Dr. Conway noted that CMS is:
- Modifying the 2011 electronic prescribing measure to say that a qualified electronic prescribing system for the purpose of the Medicare eRx Incentive Program includes certified EHR technology under the Medicare and Medicaid EHR Incentive Programs.
- Adding four additional significant hardship exemptions that will make professionals exempt from the 2012 payment adjustment:
- Eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Program and adopt certified EHR technology;
- Eligible professionals who are unable to electronically prescribe due to local, state, or federal law or regulation;
- Eligible professionals who have limited prescribing activity; and
- Eligible professionals who have insufficient opportunities to report the e-prescribing measure due to limitations of the measure’s denominator.
The two hardship exemptions already available to professionals are (1) eligible professional or group practice practices in rural areas with limited high speed internet access; and (2) eligible professional or group practice practices in an area with limited available pharmacies for electronic prescribing.
- Extending the deadline for requesting significant hardship exemptions to November 1, 2011.
- Allowing providers to report significant hardship exemptions to the 2012 eRx payment adjustment via a Web-based tool for eligible professionals or via a mailed letter for group practices that are participating in the eRx group practice reporting option for 2011.
Also a recent article from MedPage Today, physicians who use a qualified e-prescribing system are eligible for an additional 1% in Medicare Part B payments in 2011 and 2012, and a 0.5% increase in 2013. Providers who fail to complete at least 10 paperless prescriptions using a qualified e-prescribing system between Jan. 1 and June 30, 2011, will receive a 1% cut in Medicare reimbursements in 2012, a 1.5% cut in 2013, and a 2% cut in 2014.
In a proposed rule from May, CMS said doctors who are unable to e-prescribe should apply for a “hardship exemption” before Oct. 1. In the final rule issued Sept. 1, CMS announced doctors now have until Nov. 1 to apply for an exemption.
The American Medical Association (AMA) said it appreciates the one-month extension on the waiver deadline, but is worried that physicians will have just two months to apply before CMS begins tracking whether doctors are filing e-prescriptions.
“We are pleased that CMS has provided more flexibility under the exemption categories and that they have extended the deadline for physicians to apply for an exemption until Nov. 1,” said Cecil Wilson, MD, immediate past-president of the AMA. “However, we had hoped for even greater flexibility, including an additional reporting period. We remain concerned that physicians will be hit with a penalty and are not being given enough time to comply with the e-prescribing program criteria to avoid this penalty.”
The final rule is “a positive movement in the right direction” toward consolidation and clarification, Mary Griskewicz, senior director of health information systems for the Healthcare Information and Management Systems Society said in an interview.
“Aligning e-prescribing incentives and certified EHR technology is a good move,” Sharon F. Canner, senior director of advocacy programs for the College of Healthcare Information Management Executives said in an interview. “With previous legislation they have not been aligned so it’s really important that they have done that,” she said. “We hope that CMS will continue to move down this path in harmonizing across Health IT related programs—big underline under harmonization.”