Beginning in January, 2012, eligible professionals who are not successful electronic prescribers (eRx) based on claims submitted between January 1, 2011 and June 30, 2011, may be subject to a payment adjustment on their Medicare Part B Physician Fee Schedule (PFS) covered professional services.
In 2012, the payment adjustment for not being a successful eRx will result in an eligible professional or group practice receiving 99% of their Medicare Part B Physician Fee Schedule (PFS) amount that would otherwise apply to such services. In 2013, an eligible professional or group practice will receive 98.5% of their Medicare Part B PFS covered professional services for not being a successful eRx.
In 2014, the payment adjustment for not being a successful eRx is 2%, resulting in an eligible professional or group practice receiving 98% of their Medicare Part B PFS covered professional services.
CMS offers the following advice on how to avoid the 2012 e-prescribing penalty:
Eligible professionals: An eligible professional can avoid the 2012 eRx Payment Adjustment if he or she:
· Is not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of Jun 30, 2011 based on primary taxonomy code in NPPES
· Does not have prescribing privileges. Note: the provider must report (G8644) at least one time on an eligible claim prior to June 30, 2011
· Does not have at least 100 cases containing an encounter code in the measure denominator
· Becomes a successful eRx
· Reports the eRx measure for at least 10 unique eRx events for patients in the denominator of the measure.
Group Practices - For group practices that are participating in eRx GPRO I or GPRO II during 2011, the group practice MUST become a successful eRx. Depending on the group’s size, the group practice must report the eRx measure for 75-2,500 unique eRx events for patients in the denominator of the measure.
For additional information, you are encouraged to visit the section of the CMS website dedicated to e-prescribing information: http://www.cms.gov/erxincentive
