CMS has issued a final rule for the E-Prescribing program

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CMS has issued a final rule for the E-Prescribing program that includes additional hardship exemptions and allow providers more time to apply for an exemption.

Providers who do not meet the E-Prescribing requirements face cuts in their Medicare Fees in 2012 and 2013. Under the program providers who did not report 10 electronic prescriptions by June 30 face a 1% cut in fees for 2012, and providers who do not report 25 electronic prescriptions by December 31 face a 1% cut in Medicare fees for 2013

Providers who are granted hardship exemptions will be excmpt from thes fee cuts. The deadline for requesting a significant-hardship exemptions to Nov. 1, these exemptions currently only apply to the 2012 fee cuts.

CMS will be accepting exemption requests via a web based form or a paper submission.

The additional hardship exemptions are:
The provider registered to participate in the Medicare or Medicaid electronic medical record incentive programs and adopted certified EMR technology.
The provider has been unable to prescribe electronically due to local, state or federal law or regulation.
The provider had limited prescribing activity.
The provider has insufficient numbers of eligible patient visits during which to report the e-prescribing measure.

The following providers are exempt from the payment adjustment:
A health professional who is not a physician, nurse practitioner or physician assistant as of June 30, 2011.
Professionals with fewer than 100 eligible patient encounters, such as new and established patient office visits, between Jan. 1 and June 30, 2011.
Physicians and group practices with less than 10% of their Medicare charges eligible for e-prescribing.
Professionals with at least 10 e-prescribing encounters reported on claims to CMS between Jan. 1 and June 30, 2011.
Professionals who apply for a hardship exemption by Nov. 1, 2011, and receive CMS approval.

It is important to realize that simply applying for a hardship exemption is not a guarantee of CMS approval. Part of the hardship exemption application it is expected that the provider will need to describe the nature of the situation. In our opinion if the provider requests the exemption based upon adoption of certified EMR technology, it is in the best interest of the provider to start reporting E-Prescribing activity immediately. It is also important that if you are claiming the exemption for adoption of certified technology that you register with CMS at http://www.cms.gov/EHRIncentivePrograms