'Duplicative' e-prescribing, EHR incentive schedules to be modified, aligned

The Centers for Medicare and Medicaid Services (CMS), under increasing pressure from providers to modify potential conflicts in its electronic prescribing incentives schedule with its electronic health record (EHR) incentive program, suggested changes in a proposed rule published in the June 1 Federal Register.

Responding to claims that the schedules were "administratively confusing, cumbersome, and unnecessarily duplicative," CMS has proposed expanding the exemptions--and the time to report them--so providers can avoid the payment penalties.

Under the initial e-prescribing requirements released in 2009, providers were required to e-prescribe 10 orders between Jan. 1 and June 30, 2011, to avoid a 1 percent Medicare payment cut in 2012. The CMS proposed rule calls for giving providers who fail to meet current requirements a second chance by reporting one of several hardship exemptions through a special website by Oct. 1.

One of the exemptions includes letting providers delay purchase of an e-prescribing system because they intend to participate in the EHR incentive program for 2011. Also, providers who prescribe drugs could qualify for an exemption if they don't write many prescriptions, or work in an area that restricts e-prescribing, such as prohibitions on paperless orders for narcotics.

The proposed rule also revises the original description of qualified e-prescribing systems so it would include certified EHR technology under Meaningful Use, reports Government Health IT.

CMS said that the changes currently proposed could make as many as 109,000 providers eligible for exemptions. As many as 209,000 providers nationwide would have been in line for the 2012 penalties unless they reached the 10 percent e-prescribing level by June 30.

Also, in an ironic twist, CMS is accepting public comments until July 25--and therefore won't finalize the changes before that date: This means that providers may find themselves with not much time to apply for exemptions by Oct. 1, InformationWeek reports.

For more information:
- see the CMS announcement
- view the Federal Register notice (.pdf)
- read the Government Health IT article
- see the InformationWeek Healthcare article

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