The Centers for Medicare and Medicaid Services has proposed modifying e-prescribing rules so more physicians could claim exemptions from the criteria and therefore avoid being penalized in 2012.
In a conference call, agency officials said the change was in response to indications from providers and professional societies that many prescribers might not be able to meet the requirements of the current incentive program.
“Today's rule demonstrates that CMS is willing to work cooperatively with the medical professional community to encourage participation in electronic prescribing,” Dr. Patrick Conway, chief medical officer at CMS and director of the agency's Office of Clinical Standards and Quality, said in a statement.
“These proposed changes will continue to encourage adoption of electronic prescribing while acknowledging circumstances that may keep health professionals from realizing the full potential of these systems right away,” he said.
Under the current incentive program, eligible prescribers were due to get a 1% bonus payment for 2011 and 2012 and a 0.5% bonus in 2013. For prescribers who did not meet the criteria, there would be a penalty imposed in 2012. The penalty would escalate in 2013 and 2014.
The final Medicare Physician Fee Schedule for 2011 contains exceptions, along with two hardship exemptions. Practices are exempt if they are in a rural area without high-speed Internet access or an area without enough available pharmacies for electronic prescribing.
Under the proposed rule, prescribers who use certified EHRs can now claim this as a “qualified” e-prescribing system. The move was designed to more closely align the e-prescribing program with the program that offers incentives for meaningful use of EHRs.
The proposed rule would also create four additional hardship exemption categories. Prescribers would have to show 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.
▸ Insufficient opportunities to report the electronic prescribing measure due to limitations on the measure's denominator.
Prescribers also would be granted an extension, until Oct. 1, 2011, to apply for the hardship exemption.