CMS Postpones the eRx Penalty Exemption Date to November 8th

The deadline for claiming an exemption from penalties from the e-Rx (MIPPA) federal program has been extended from November 1st to November 8th.

As part of the effort to reconcile different federal programs, with different criteria and different specific structures implementing them – the stand-alone electronic prescribing program (MIPPA) enacted in 2008, and the EHR Incentive Program (Meaningful Use) enacted in 2009 and which includes eRx as one of its criteria – the Centers for Medicare and Medicaid Services (CMS) issued a ruling that tried to blend the two programs.

The MIPPA eRx program was a Medicare program that gave a slight incentive boost to Medicare payments if Eligible Professionals could demonstrate themselves to be successful e-prescribers. After a few years of incentives, the MIPPA law then carried a penalty phase, which will go into effect (for the first time) in 2012 for unsuccessful e-prescribers. This penalty will be a 1% pay reduction in Medicare payments in 2012.

In order to avoid such penalties, prescribing clinicians needed to submit (via claims) at least 10 G-codes (G8553) with bills for office-based service during the first half of 2011 (up through June 30th). Failure to do so would result in penalties in 2012.

The only option was to claim an exemption – and there were a handful of them that applied only to a few, rare circumstances (like no pharmacies accept e-Rx in my service area, or there is no Internet in my service area, etc.). But, as we noted in September, CMS added a new exemption: implementing a Certified EHR and registering for Meaningful Use counted as an exemption from penalties.

The web form that was initially set up to receive applications for Meaningful Use-based eRx penalty exemptions (see it here) initially had an error in it – the CMS EHR Certification ID Number field, where you stated which software you were using to achieve Meaningful Use, only accepted 13 digits, instead of the 15 digits that these numbers contain.

CMS has subsequently fixed this problem, and has also extended the deadline to November 8th.

To review, in order to submit a request for eRx Initiative exemption (and therefore avoid penalties in 2012), follow the following steps:

1. Go to the PQRS site: https://www.qualitynet.org/portal/server.pt/community/pqri_home/212
2. In the “Related Links” box (upper left), open the “Communications Support page.” This will open an online form
3. Fill out the form fields, including all the identifying information requested
4. Check the “eRx Payment Adjustment Feedback Report”
5. Check the first option, and indicate your EHR Incentive Program Registration ID#, and the ONC Certification number of the product you are using (for Practice Fusion, it is 30000004H0RCEA0)
6. Add a descriptive justification in the text box. We suggest something like “I am an active e-prescriber using Certified EHR technology, and will demonstrate this through the EHR Incentive Program eRx criterion”
7. Attest to the accuracy of the information and submit

The following is a step-by-step illustration of the process:

Practice Fusion draws from a community of doctors, medical experts, and digital health influencers that contribute to blog posts. Read all posts from our guest writers

Read all posts by Contributing Writer