Skip to content

CMS Issues Final Rule on E-Prescribing

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: September 06, 2011 WASHINGTON — Doctors now have an extra month to apply for a hardship waiver to avoid being penalized for not adopting electronic prescribing in their practices, according to a final rule issued by the Centers for Medicare and Medicaid Services (CMS).

Physicians who use a qualified e-prescribing system are eligible for an additional 1% in Medicare Part B payments in 2011 and 2012, and a 0.5% increase in 2013. Providers who fail to complete at least 10 paperless prescriptions using a qualified e-prescribing system between Jan. 1 and June 30, 2011, will receive a 1% cut in Medicare reimbursements in 2012, a 1.5% cut in 2013, and a 2% cut in 2014.

In a proposed rule from May, CMS said doctors who are unable to e-prescribe should apply for a “hardship exemption” before Oct. 1. In the final rule issued Sept. 1, CMS announced doctors now have until Nov. 1 to apply for an exemption.

CMS will issue exemptions to physicians who see very few patients; those who practice in rural areas without sufficient high-speed Internet access; those in areas without sufficient available pharmacies; those who have had limited prescribing activity during the six-month time frame; and those residing in an area where regulations hinder e-prescribing, such as in places that prohibit paperless orders for narcotics.

Physicians who are registered to participate in another electronic health records program — such as the Medicare or Medicaid EHR Incentive Program — will also be exempt from the 1% cut in reimbursement in 2012.

The American Medical Association (AMA) said it appreciates the one-month extension on the waiver deadline, but is worried that physicians will have just two months to apply before CMS begins tracking whether doctors are filing e-prescriptions.

“We are pleased that CMS has provided more flexibility under the exemption categories and that they have extended the deadline for physicians to apply for an exemption until Nov. 1,” said Cecil Wilson, MD, immediate past-president of the AMA. “However, we had hoped for even greater flexibility, including an additional reporting period. 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.”