Some Physicians Facing e-Rx Penalties Despite Requesting Exemptions

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Some physicians are reporting that their 2012 Medicare payment rates have been reduced for a failure to electronically prescribe in 2011, even though the physicians say that they filed for hardship exemptions from the e-prescribing program, American Medical News reports.

Notification of Penalties

Physicians who e-prescribe but failed to report at least 10 e-prescribing encounters on claims for eligible services between January 2011 and June 2011 received letters in February indicating that they would face a 1% penalty on their Medicare payment rates.

Physicians who filed for hardship exemptions from the e-prescribing requirement in the fall also received the letters. The letters indicated that CMS had not yet accounted for whether the physicians' hardship exemption applications had been received by the Nov. 8, 2011 deadline.

CMS Response

CMS officials said they were unable to process all of the hardship exemption applications prior to implementing the 1% Medicare payment penalty for noncompliant physicians.

Agency officials said that CMS now has approved or denied all exemption requests, thus requiring contractors to reprocess claims for physicians who previously had been penalized in error.

Although CMS does not have an official appeals process for the e-prescribing program, the agency has expressed a willingness to work with individual doctors about issues related to the payment penalties, according to American Medical News.

Next Steps

CMS currently is accepting hardship exemption requests from physicians seeking to avoid e-prescribing penalties in 2013, when the payment reductions will increase to 1.5% (Fiegl, American Medical News, 4/4).

Tim Colling
"...requiring contractors to reprocess claims for physicians who previously had been penalized in error." Ah, yes. The government punishes us for the mistakes and delays that they cause, as usual. It must be nice having all the power and money and no accountability.

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