CMS Eases Requirements for E-Prescribing

BY FRANCES CORREA
Elsevier Global Medical News

Based on feedback from physicians and health care providers, the final federal e-prescribing regulations are more flexible and contain more exemptions, the Centers for Medicare and Medicaid Services announced.

The changes come after concern that the program criteria should be more aligned with the Medicaid incentive program for electronic health records, according to CMS officials.

“[The changes] will encourage more doctors and other health care professionals to adopt this technology and give them the added flexibility to help them succeed,” Dr. Patrick Conway, chief medical officer at CMS and director of the agency’s Office of Clinical Standards and Quality, wrote in a blog post announcing the change. “With electronic prescribing, providers can better manage patient prescriptions, reducing drug interactions or other preventable prescription errors.” Under the Medicare Electronic Prescribing Incentive Program, eligible prescribers who meet the e-prescribing criteria will get a 1% bonus payment for 2011 and 2012 and a 0.5% bonus in 2013. Those who do not meet the criteria in 2012 will be penalized 1% of Medicare payments; the penalty will escalate in 2013 and 2014.

Under the final rule, prescribers who use certified electronic health records can claim this as a “qualified” e-prescribing system. This move was designed to more closely align the e-prescribing program with the program that offers incentives for meaningful use of electronic health records, CMS officials said.

The final rule contains hardship exemptions for those who live in a rural area without high-speed Internet access and those who work where there are not enough pharmacies that can take electronic prescriptions. In addition, the final rule creates additional hardship exemption categories. Eligible professionals have to demonstrate that they have registered to participate in the Medicare or Medicaid EHR incentive program and have adopted certified EHR technology; an inability to electronically prescribe due to local, state, or federal law (this primarily applies to prescribing of narcotics); very limited prescribing activity; or insufficient opportunities to report the e-prescribing measure.

The deadline to apply for a hardship exemption has been extended until Nov. 1, 2011, according to CMS officials.

Even with the changes, however, some physicians still have concerns. The American Medical Association said it is worried about the amount of time physicians will have to apply for the exemptions.

“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,” said Dr. Cecil Wilson, AMA immediate past president.

COMMENTARY
Dr. Stuart Garay, FCCP, comments: A crucial addition to the final regulations is the broadening of the hardship exemption categories. However, unless you fall under one of the hardship exemption categories, you should e-prescribe. In addition, there will be another 6-month reporting period in which CMS will require at least 10 more e-prescriptions under the threat of another penalty. Doctors who fail in 2012 will incur a 1.5% Medicare cut in 2013. Don’t leave money on the table!