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July 18, 2010
Article: 2012 Penalties for not E-Prescribing in Medicare Would be Based On Analyzing Provider Data for the Period 1/1/2011 through 6/30/2011
If you have not implemented E-Prescribing in your practice, you should not put it off any longer.
As of 1/1/2012 Medicare allowed amounts for individual providers will decrease by 1% if providers are not "successfully" e-prescribing for Medicare patients. Where this may seem like a long way off, CMS recently proposed the determination of whether the penalty will be imposed would be based on analyzing provider data for the period 1/1/2011 through 6/30/2011.
For claims based submission of the E-Prescribe measure, CMS would look at services billed by the provider. If there were 100 services billed where the E-Prescribe measure applied, 10 of those claims must have the code for E-Prescribing reported or the penalty would be imposed. For registry based or EHR reporting of E-Prescribe, these qualified registries or EHR vendors would need to download data to CMS during the period 7/1/2011 through 8/19/2011. The same 100 encounter rule with the minimum 10 reporting would be applied in these situations to avoid the penalty in 2012.
Exemptions to the penalty would apply if:
The provider is of a type who does not have prescribing privileges, or
Data analysis indicates there were less than 100 applicable cases where E-Prescribe should have been reported, or
Less than 10% of the providers Medicare allowed amounts are applicable for E-Prescribing reporting.
Keep in mind also that penalties for not successfully e-prescribing increase as of 2013 to 1.5% and 2% as of 2014 and beyond.
To review the E-Prescribing reporting measure specification click here
To review all information related to the CMS E-Prescribe program click here
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