The Centers for Medicare and Medicaid Services (CMS) recently announced changes to the Medicare Electronic Prescribing (eRx) Incentive Program for Calendar Year (CY) 2011. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized the establishment of a program to support the adoption and use of eRx technology. The program, implemented in 2009, offers financial incentives based on an eligible professional’s or group practice’s use of eRx technology. However, the program also requires payment reductions under certain circumstances; for example, beginning in 2012 a reduction in payment under the Medicare Physician Fee Schedule (MPFS) will be implemented for those eligible professionals or group practices who are not meeting requirements for electronic prescribing, as described in the CY 2011 MPFS final rule.
On September 6, 2011, CMS published a final rule (Final Rule) that modifies the 2011 eRx quality measure. Based on comments received by CMS that requirements under the eRx Incentive Program did not align with the Medicare Electronic Health Record (EHR) Incentive Program, CMS has revised the eRx quality measure so that eligible professionals or group practices now have the option of adopting either a qualified electronic prescribing system that performs four required functionalities or Certified EHR Technology as defined at 42 C.F.R. § 495.4 and 45 C.F.R. § 170.102. This change applies only in limited circumstances. It is only effective for the remainder of the reporting periods in CY 2011 for the 2011 eRx incentive and the 2013 eRx payment adjustment. See 76 Fed. Reg. 54956. CMS had also previously finalized two circumstances under which an eligible professional or group practice could request consideration for a significant hardship exemption for the 2012 eRx payment reduction. The Final Rule adds four additional hardship exemption categories. The Final Rule also extends the timeframe for submitting requests for a significant hardship exemption to November 1, 2011.