Docs punished for not e-prescribing, despite exemptions

Physicians who last year applied for hardship exemptions from Medicare electronic prescribing penalties have begun seeing their Medicare payments reduced by 1 percent, according to an article published in American Medical News. This turn of events fulfills earlier predictions that some doctors would be unfairly penalized because of the short window they had to file for such exemptions.

In a February letter to physicians, the Centers for Medicare & Medicaid Services (CMS) said that that the penalty did not reflect whether the applications for exemptions had been received by the Nov. 8, 2011 deadline. CMS did not release the final rule spelling out the conditions for these exemptions until late August, giving doctors only a little more than two months to apply.

Under the e-prescribing program, physicians who did not electronically prescribe at least 10 prescriptions between Jan. 1 and June 30, 2011 will lose 1 percent of their Medicare reimbursement this year unless they meet one of the exemption criteria. Among the grounds for exemption are the inability to prescribe electronically because of local, state or federal law, and limited prescribing activity.

Last July, the American Medical Association and 91 specialty societies criticized CMS' proposed e-prescribing penalty rules, partly because of the short window for exemption applications.

According to amednews, CMS says it has now completed approving or denying the hardship applications. Medicare carriers will retroactively adjust payments to physicians whose hardship applications have been approved, the agency said.

CMS is now accepting applications for exemptions to avoid the 2013 e-prescribing penalties. Physicians must prescribe electronically 10 times between Jan. 1 and June 30 of this year to avoid a 1.5 percent reduction in Medicare payments in 2013. In addition, doctors who prescribed electronically at least 25 times in 2011 to get a CMS bonus will not be penalized in 2013. Hardship exemptions must be filed by June 30 of this year.

To learn more:
- read the American Medical News story

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