November 1 is the Deadline to Apply for a Medicare E-Prescribing Exemption!

Most physicians must have successfully e-prescribed in the first six months of 2011 to avoid a 1% penalty on their 2012 Medicare fees. If you did not successfully e-prescribe, you may be eligible for an exemption, but you must apply by November 1. 

Some physicians who were not eligible for the e-prescribing incentive program, may not be subject to the 1% penalty. However, those physicians must do the calculations to determine if they fall into these ineligible categories. Ineligible categories include: physicians who had less than 100 claims that fall in the e-prescribing measure specifications; or physicians whose e-prescribing measure specifications represented less than 10% of their allowable part B charges. The time period to calculate these two categories is between January 1, 2011 and June 30, 2011. View an MSNJ tip sheet on how to calculate the 10% eligibility threshold. Physicians will have to review all claims submitted to determine if they have less than 100 cases.)

While CMS has stated that no action is necessary on the part of physicians who fall into these two categories, MSNJ has learned that Highmark Medicare Services will not be able to indicate to physicians whether they fall into these two categories based on their claims data before the November 1, 2011 exemption filing deadline.  Therefore, practices should carefully consider whether it is in their best interest to file for an exemption, explaining their situation before the November 1 deadline.

To assess whether or not your practice is likely to fall into the “less than 10%” category, view AMA’s Medicare charges by specialties chart, read CMS’ updated notes and claims-based reporting principles for eRx incentive program, and AMA’s tips to avoid eRx penalty.

Remember, each physician must calculate whether he or she falls into an eligible category. And, even though CMS says that no action is necessary, consider whether or not it is prudent to file for an exemption nevertheless.

National Provider Call on PQRS & E-Prescribing Incentive Program 
CMS is hosting a PQRS & E-Prescribing Incentive Program National Provider Call on Tuesday, October 18 from 1:30 P.M. to 3:00 P.M. This call will cover: program announcements, overview of the Medicare E-Prescribing Incentive Program Feedback Reports, and a Q&A. Register online by October 18.

Teleconference: E-Prescribing & Physician Quality Reporting System (PQRS) 
Highmark Medicare Services will host a teleconference on E-Prescribing & Physician Quality Reporting System (PQRS) on October 17, 2011 at 9:00 A.M. and October 20, 2011 at 1:00 P.M. They will review the Physician Quality Reporting System and E-prescribing Incentive Programs and provide an overview of the websites to locate incentive information. Teleconference instructions and handout materials are now available.


About MSNJ

Founded in 1766, the Medical Society of New Jersey is the oldest professional society in the United States. The organization and its dues-paying members are dedicated to a healthy New Jersey, working to ensure the sanctity of the physician–patient relationship. In representing all medical disciplines, MSNJ advocates for the rights of patients and physicians alike, for the delivery of the highest quality medical care. This allows response to the patients’ individual, varied needs, in an ethical and compassionate environment, in order to create a healthy Garden State and healthy citizens.

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