Eligible professionals (EP) and group practices need to participate in the electronic prescribing (eRx) incentive program or meet exclusion criteria by June 30, 2013 to avoid a 2014 Medicare Part B payment adjustment of 2%.  January 1-June 30, 2013 is the final reporting period to avoid this adjustment.

There is no sign-up or pre-registration for individual eligible professionals to participate in the eRx Incentive Program. However, there are certain limitations on who can qualify for an eRx incentive payment. Learn more about EP participation criteria or the group practice reporting option.

An individual eligible professional  or group practice who self-nominated to participate will not be included in analysis for the 2014 eRx payment adjustment if of one of the payment adjustment exclusion criteria apply.  See  CMS 2014 Payment Adjustment document for complete list of exclusion.

Automatic Exclusion. Participation in the EHR incentive program offers automatic exclusion to the eRX payment adjustment. This exclusion is determined by CMS through review of the EHR Incentive Program registration system and will be automatically processed when:

  • Those eligible professionals and members of a group practice achieve Meaningful Use under the Medicare or Medicaid EHR Incentive Program during the 12-month eRx reporting period (1/1/12-12/31/12) or the 6-month eRx reporting period (1/1/13-6/30/13) and attests during the 6-month reporting period (1/1/2013-6/30/13).

OR

  • Those eligible professionals and members of a group practice demonstrate intent to participate in the Medicare or Medicaid EHR Incentive Program by registering and adopting (providing EHR certification ID) certified EHR technology by June 30, 2013.

Other Hardship Exclusions. CMS may exempt individual  EPs and group practices from the 2014 payment adjustment if it’s determined that compliance with the eRx requirement would result in  a significant hardship. Hardship exemptions must be submitted in advance of the June 30 deadline and  include:

  • Inability to electronically prescribe due to state, or federal law, or local law or regulation
  • The eligible professional prescribes fewer than 100 prescriptions during a 6-month payment adjustment reporting period
  • The eligible professional practices in a rural area without sufficient high-speed Internet access (reportable via claims as G8642)
  • The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing (reportable via claims as G8643)

Submitting a Hardship Request.  CMS established the PQRS Communication Support Page (see link in upper-left hand corner of webpage) for eligible professionals and 2013 eRx GPRO primary contacts to submit hardship requests, including those associated with a G-code.