Organized medicine wants more Medicare e-prescribing changes

Medicare must give physicians additional time to meet requirements before the 2012 penalty is applied, medical associations say.

By Charles Fiegl — Posted Aug. 4, 2011

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Physician organizations have called for additional changes to Medicare's electronic prescribing initiative, which they said could penalize doctors unfairly starting Jan. 1, 2012, for not meeting program requirements.

The American Medical Association and 91 state and specialty medical societies commented on proposed changes to the e-prescribing incentive program run by the Centers for Medicare & Medicaid Services. Eligible doctors and other health professionals could see their Medicare payments reduced by 1% in 2012 for failing to report e-prescribing activity during the first six months of 2011.

On May 26, CMS issued a proposed regulation with several adjustments to the program, which would give physicians until Oct. 1 to claim one of several hardship exemptions and avoid being penalized. The proposal also would make it easier for physicians using certified electronic medical record systems to satisfy e-prescribing system requirements at the same time they are earning Medicare or Medicaid meaningful use bonuses.

But the AMA and the other physician associations still are concerned about the government applying 2012 penalties based on 2011 e-prescribing activity. The Association urged CMS to add another reporting period in 2012, from January through June, for physicians to report e-prescribing activity to avoid the pay penalty.

"Physicians are working hard to adopt e-prescribing and other health IT and should not be unfairly penalized for practice patterns that do not fit neatly within the current, limited exemption process," said Cecil B. Wilson, MD, AMA immediate past president.

The joint letter also recommended that CMS:

  • Maintain the new hardship exemptions throughout the e-prescribing penalty program. The proposed exemptions are for health professionals who can't e-prescribe because of a federal, state or local law; those who infrequently prescribe medicine; or those with insufficient opportunities to e-prescribe medicine.
  • Add an economic hardship exemption for physicians who intend to retire within the next several years.
  • Hold off on applying the 2012 penalty until 2013, which is when CMS will pay 2012 e-prescribing bonuses.
  • Allow physicians to apply for exemptions by phone and in writing. CMS has proposed using an online tool to report hardships.
  • Collaborate with physician organizations to develop uniform outreach materials in a timely manner before the Oct. 1 deadline.
  • Create an appeals process for eligible physicians and group practices that are denied a hardship exemption.

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