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ACS Medicare Electronic Prescribing (eRx) Incentive Program


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2013 Medicare Electronic Prescribing Hardship Exemption

You still have time to apply for the 2013 Medicare Electronic Prescribing (eRx) hardship exemption.

You should apply for an exemption if you are an eligible professional who:

• Was unable to report at least 25 electronic prescriptions in conjunction with specified evaluation and management (E and M) visits from January 1 through December 31, 2011

• Is unable to report on any 10 electronic prescriptions (the any 10 electronic prescriptions do not have to be associated with the specified E and M eligible visits, but must be submitted in conjunction with a billable, covered procedure not associated with a global period) from January 1 to June 30, 2012

• Is not automatically exempted from the program, or are unsure if you are automatically exempt from the program. Eligible professionals are automatically exempt if:

1. they are not a MD, DO, podiatrist, nurse practitioner, or physician assistant by June 30, 2012 or,

2. do not have at least 100 Medicare Part B physician fee schedule cases containing an encounter code in the measure’s denominator* for dates of service from January 1 to June 30, 2012 or,

3. do not have at least 10 percent or more of the EP’s Medicare Part B physician fee schedule charges are not from codes in the denominator* of the measure for dates of service from January 1 to June 30, 2012 or,

4. do not have prescribing privileges and reported G8644 on a billable Medicare Part B service at least once on a claim between January 1 to June 30, 2012

*denominator eligible codes are as follows:
90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109

To apply for a significant hardship exemption in order to avoid receiving a 1.5 percent Medicare Part B payment penalty for 2013, eligible professionals and group practices participating in the group ( Click Here For A Copy Of The Group Practice Reporting Option ) (GPRO) must apply by June 30th, 2012 for the 2013 Medicare eRx significant hardship exemption. Even if you applied for an eRx significant hardship exemption last year to avoid the 2012 eRx payment penalty and were approved by CMS, you must reapply to avoid the 2013 payment penalty.

To assist you with the hardship exemption request process, the American College of Surgeons (ACS) advocacy and health policy staff developed a step-by-step guidance document that explains how to apply for the hardship exemption ( Click Here For A Copy Of The Step By Step guide ) When applying for the significant hardship exemption on the CMS Web site, please make sure to use Microsoft Internet Explorer 9.

For more information on the Medicare e-Prescribing program and to determine if you are an eligible professional, please review the e-Prescribing article published in the May 2012 issue of the ACS Bulletin at:

Click Here For A Copy Of The May 2012 issue of the ACS Bulletin

Additional information: • Visit the ACS eRx website, (Click Here To Visit The ACS eRx website)
or contact the ACS Washington Office at 202-337-2701 or ( Click Here To E-Mail The College)

• CMS on the e-Prescribing program, (Click here To Visit The E-Prescribing Incentive Program ), or 1-866-288-8912

• A copy of the Final Rule, Click Here


Should you have any questions, please feel free to call me.
Thanks.
Andrea

Andrea Donelan
Executive Director
36 Elm Street, Suite 5
Morristown, NJ 07960
(973) 539-4000
FAX: (973) 539-9493
Chapter E-Mail

Medicare Electronic Prescribing (eRx) Incentive Program
Incentive and penalties for each year



e- Prescribing Coding Information


IMPORTANT NOTICE!
e-PRESCRIBING RULES



E-Prescribing 2012 Hardship Exemption Requests to Avoid the 2013 Payment Adjustment Individual eligible professional requesting hardship exemptions from the 2013 eRx payment adjustment will be able to submit their request using the CMS Quality Reporting Communication Support Page located at https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234
CMS will announce when the Quality Reporting Communication Support Page becomes available for requesting a hardship exemption for the 2013 eRx payment adjustment. For more information on the 2012 eRx hardship exemption categories and on the process for requesting an exemption visit the CMS Electronic Prescribing Incentive Program at http://www.cms.gov/ERxIncentive



The Centers for Medicare and Medicaid Services has released the final rule regarding ePrescribing. The final rule provides greater flexibility to physicians who are unable to meet all the program requirements to apply for an exemption. The deadline to apply for an exemption has also been extended to November 1. The rule allows physicians who are otherwise eligible for the ePrescribing program to request a "hardship exemption" from the 2012 penalties for any of the following reasons:

• Inability to ePrescribe due to local, state, or federal regulations (i.e., the majority of their prescriptions are for controlled substances);
• Insufficient opportunity to ePrescribe because the bulk of prescribing activity occurs during visits other than the specified CPT codes (e.g., post-surgery visits);
• Insufficient prescribing activity. To submit a request for exemption, physicians must:

* Access the exemption request form at Click for Exemption request Form
* Provide identifying information (TIN, NPI, name, mailing address, e-mail address).
* Identify the hardship category under which you are requesting an exemption. If more than one applies, include the second in the justification statement.
* Submit a justification statement explaining how ePrescribing represents a significant hardship (the statement needs to be compelling, because there is no appeal process—the decision of CMS is final).
* Attest to the accuracy of the above information. Requests will be accepted through November 1, but physicians are encouraged to apply as soon as possible to avoid any potential reprocessing of claims.

Should you have any questions, please feel free to contact the Chapter office.
Thank you for your attention to this matter.



Andrea Donelan,
Executive Director
(973) 539-4000
Chapter E-Mail



American College of Surgeons e-Perscribing Information

Please note there are some EHR companies which offer free e-Prescribing solutions. The New Jersey Chapter or the ACS does not endorse any of the available solutions and recommends you do your own due diligence before making a decision.