CMS proposes new eRx hardship exemptions, Physician Compare reports

As part of proposed changes to its physician fee schedule, the Centers for Medicare and Medicaid Services (CMS) has proposed changes to its health IT programs, including the electronic-prescribing incentive program, the Physician Quality Reporting System (PQRS) and the Physician Compare website.

At the top of the agenda for physicians is CMS' decision to add two new "hardship" exemptions to the electronic prescribing incentive program, which specifies that providers who do not e-prescribe will lose a small portion of their Medicare reimbursement.

CMS now concedes that physicians might have difficulty achieving Meaningful Use of certified EHR technology at the same time that they have must show they are prescribing electronically. So for the e-prescribing payment adjustment periods of 2013 and 2014, the agency proposes not to penalize non-prescribing eligible professionals or group practices if they achieve Meaningful Use.

CMS also wants to exempt EPs or groups that show intent to participate in the EHR incentive program. However, they would have to register for either the Medicare or the Medicaid incentive program and would have to adopt certified EHR technology by a date that CMS will specify.

CMS has received major pushback from the American Medical Association and other medical societies over its penalties for non-prescribing physicians. Recently, it was reported that physicians who had applied for hardship exemptions last year were starting to lose 1 percent of their Medicare reimbursement. Physicians who did not electronically prescribe at least 10 times during the first six months of this year will lose 1.5 percent of their payments next year unless they qualify for a hardship exemption.

CMS also provided more details of how it plans to report physician quality data on its Physician Compare website. Sometime in 2014, it intends to start posting PQRS data supplied by group practices, as well as data that accountable care organizations must report if they participate in the Medicare Shared Savings Program. The minimum number of patients who must be included in each measure would be lowered from 25 to 20 under CMS' proposal.

Further down the line, CMS said, it wants to release patient experience data on physicians participating in PQRS. Some of this would be in the form of Consumer Assessment of Healthcare Providers and Systems (CAHPS) data.

CMS also said it would further integrate quality reporting to PRQS with reporting requirements under the EHR incentive program. For the latter initiative, it proposed continuing to use the same method of quality reporting that was included in the final version of last year's fee schedule.

To learn more:
- read the proposed CMS rule

Suggested Articles

Welcome to this week's Chutes & Ladders, our roundup of hirings, firings and retirings throughout the industry.

Women and family health startup Maven landed $45 million in series C funding with some high-profile backers.

Over 41 million patient records were breached in 2019 as the healthcare industry faces new hacking techniques and threats.