October 22, 2021

Volume XI, Number 295

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CMS Releases Proposed Rule for the Electronic Prescribing Incentive Program

The Centers for Medicare & Medicaid Services issued May 26th  a proposed rule with changes to the Medicare Electronic Prescribing (eRx) Incentive Program. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized the Secretary of Health and Human Services to establish a program to encourage the adoption and use of eRx technology. The program, implemented in 2009, offers financial incentives and payment adjustments to eligible professionals.

Under the eRx Incentive Program, eligible professionals who are electronic prescribers can receive a 1% incentive payment for program years 2011 and 2012 and a .5% incentive payment for 2013. Beginning in 2012, a Medicare Physician Fee Schedule (PFS) payment adjustment is required for those eligible professionals who are not successful electronic prescribers. The PFS adjustment amount will be 1% less in 2012 than the PFS amount that would otherwise apply, 1.5% less in 2012, and 2% less in 2014.

The proposed rule makes the following changes to the program:

  1. Modifies the 2011 eRx quality measures (available for download here);
  2. Provides additional significant hardship exemption categories that eligible professionals and group practices may request for the 2012 eRx payment adjustment; and 
  3. Extends the deadline for requesting consideration of hardship exemptions. The new deadline applies to the two categories of hardship exemptions finalized in the 2011 Medicare PFS final rule and the proposed additional categories. Significant hardship exemption requests must be postmarked or submitted via a web-based tool proposed in the rule by October 1, 2011. However, the web-based tool submission is conditioned upon the development of such a tool prior to publication of the final rule.

The proposed rule is scheduled to be published in the Federal Register on June 1, and the comment period closes on July 25.

To view the proposed rule, visit the following link (file code CMS-3248-P). For more information regarding which professionals are “eligible professionals” for purposes of the eRx Incentive Program, please visit the following link. 

©2021 von Briesen & Roper, s.cNational Law Review, Volume I, Number 150
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About this Author

von Briesen & Roper’s Health Law Section provides comprehensive legal services to the health care industry nationwide as both general counsel and special project counsel. Our clients include integrated delivery systems, academic medical centers, community hospitals, Catholic-sponsored hospitals, rural and critical access hospitals, imaging centers, physicians and multi-specialty clinics, specialty hospitals, ancillary suppliers, home health agencies, nursing homes, hospices, assisted living facilities, mental health and AODA facilities, DME suppliers, laboratories,...

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