Medicare E-Prescribing Exemptions Are Expanding

On May 26th, CMS released a proposed rule that would give physicians another way to avoid a 1% cut in Medicare payments in 2012 if they have failed to complete at least 10 paperless drug orders using an e-prescribing system in the first half of 2011.

While the original E-prescribing rule made exemptions for rural physicians with limited Internet access or doctors in areas with few pharmacies accepting electronic prescriptions (and only if the exemption was claimed before June 30, 2011), the proposed rule includes recognizing the following hardships:

• Physicians who have limited prescribing activity
• Physicians who have delayed purchasing an e-prescribing system because they intend to participate in the Medicare electronic medical record incentive program in 2011
• Physicians who live in an area where regulations prevent e-prescribing, including prohibition of paperless orders for narcotics
• Physicians who e-prescribe, but only for types of visits that do not count towards the 10-order minimum necessary to avoid the mandated reduction in Medicare payments

The CMS proposal  includes the plan to develop a website where physicians would report such hardships.  In addition to having multiple ways to register their hardship, the proposal would allow more time for physicians to indicate the reason(s) they were unable to e-prescribe, by setting a new deadline of October 1, 2011. Additionally, the proposed rule will make it easier for practices that already utilize certified EMRs to use those systems to satisfy the e-prescribing requirements.  

CMS is accepting public comments on this proposal until July 25th.  The entire proposed rule can be found here:   (www.ofr.gov/ofrupload/ofrdata/2011-13463_pi.pdf).