What Prescribers wish Pharmacists knew about Electronic Prescriptions: Tips for pharmacies from the prescribing side that can make the process of adoption smoother for everyone.
Implementation I-STOP: The Internet System for Tracking Over-Prescribing, or I-STOP, was signed into law Aug. 27, 2012. The I-STOP bill requires the creation of a “real time” prescription tracking system to provide enhanced information to prescribers and pharmacists concerning prescriptions obtained by patients for controlled substances. To access the database, all physicians will need a Health Commerce Account. Read a summary of the bill. Apply for a Health Commerce System (HCS) account. Download application instructions.
Effective February 23, 2013, all forms of hydrocodone will be considered Schedule II Controlled Substances in NYS,and Tramadol will be added to Schedule IV list of controlled substance. A list of frequently asked questions is available on the NYS Department of Health website.
Medicare 2013 eRx Payment Hardship Exemption Requests: Beginning November 1, The Centers for Medicare and Medicaid Services will re-open the Quality Reporting Communication Support Page to allow individual eligible professionals to request a significant hardship exemption for the 2013 eRx payment adjustment. Request should be submitted via the Quality Reporting Communication Support Page on or between Nov. 1, 2012 - Jan. 31, 2013
2012 Medicare e-Prescribing Penalty Exemptions: The AMA has secured an opportunity for more physicians to be exempted from the 2012 Medicare e-prescribing penalty. Read more.
2012 Rx Payment Adjustment FAQ
CMS continues to receive inquiries about the Medicare electronic prescribing (eRx) incentive program and the 2012 eRx payment adjustment. The following key information is provided by CMS to clarify the issues that the agency has heard from physicians and other health-care professionals.
- Statutory Authority/Background
CMS is required to adjust the payments of eligible professionals who are not successful electronic prescribers beginning in 2012. This requirement is outlined in Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
CMS listed the requirements for being a successful e-prescriber for purposes of avoiding the 2012 payment adjustment in the 2011 Physician Fee Schedule final rule. In February 2012, all eligible professionals who did not meet these requirements were sent a letter notifying them of this fact.
- Significant Hardship Exemption Requests
In response to stakeholder feedback, CMS also published a standalone eRx rule on Tuesday, Sept. 6, 2011, to provide additional circumstances under which eligible professionals would qualify for hardship exemptions. Eligible professionals initially had until Tuesday, Nov. 1, 2011, to submit a request for a hardship exemption for the 2012 eRx payment adjustment via the newly-created quality reporting communication support page; this deadline was later extended to Tuesday, Nov. 8, 2011. CMS finished its review of these requests in February 2012 and continues to notify requestors via email whether their request was approved or denied.
- Questions and Concerns
Although there is no appeal or review process established for the eRx Incentive Program and payment adjustment, CMS encourages eligible professionals with questions or concerns about the eRx payment adjustment and hardship exemption requests to contact the QualityNet Help Desk. Through the help desk, CMS is working with eligible professionals and CMS-selected group practices that have questions about eRx payment adjustments and/or hardship exemption decisions. CMS is handling all hardship exemption requests and any questions or concerns on a case-by-case basis. Contact the help desk if you have issues relating to the eRx payment adjustment and/or the rationale for denial of your hardship exemption request. The QualityNet Help Desk can be reached Monday through Friday from 7 a.m. to 7 p.m. CMT, at 866-288-8912 or via email at QNetSupport@sdps.org.
- 2013 & 2014 eRx Payment Adjustment
Please note that payment adjustments under the eRx Incentive Program run until 2014. For information on how to avoid the 2013 and 2014 eRx payment adjustments, please visit the eRx Incentive Program Web page and review MLN Matters Article #SE1206.
CMS has created a number of useful resources for eligible professionals participating in the Medicare Electronic Prescribing (eRx) Incentive Program, including:
2012 eRx Incentive Program: Future Payment Adjustments – This article provides guidance on avoiding future eRx Incentive Program payment adjustments for individual eligible professionals and selected group practices participating in the 2012 eRx Group Practice Reporting Option (GPRO).
2012 Physician Quality Reporting System and eRx Incentive Program Group Practice Reporting Option: Participation for the Incentive Payment Made Simple – This factsheet provides guidance for group practices wishing to participate in the 2012 Physician Quality Reporting System and the 2012 eRx Incentive program as a CMS selected group practice.
2012 eRx Incentive Program: Participation for the Incentive Payment Made Simple – This factsheet provides step-by-step advice for participating in the 2012 eRx Incentive Program.
2012 eRx Incentive Program Updates for 2012 – This factsheet contains information about changes to the eRx Incentive Program for 2012 and future payment adjustments as authorized by MIPPA.
To access these and other educational products on the Medicare eRx Incentive Program, visit the “Educational Resources” section of the Electronic Prescribing Incentive Program webpage.
In the News
E-Prescribing Hardship Exemption Deadline Extended to Nov. 8: After hearing from the AMA about difficulty accessing the CMS Communication Support Page, the Centers for Medicare and Medicaid Services has extended the deadline to file for an e-prescribing hardship exemption until Tuesday, Nov. 8. If you’re not sure whether you qualify for an exemption, the AMA suggests that you apply anyway. There is no appeals process after the fact. Read more.
eRx Incentive Hardship Exemption: The deadline to request a hardship exemption for the 2012 Medicare Electronic Prescribing (eRx) Incentive Program adjustment is November 1, 2011. Eligible professionals should determine if they are subject to the 2012 eRx payment adjustment by reviewing the MLN Article SE1107. If you believe you may be subject to the 2012 eRx payment adjustment, you should determine if you meet any of the hardship exemption categories specified by CMS in the 2011 Medicare Electronic Prescribing (eRx) Incentive Program Final Rule. A Quick Reference Guide is available to help you understand the changes the eRx Final Rule made to the 2011 Medicare eRx Incentive Program, including the November 1 exemption deadline.
Medicare eRx: CMS released the final rule for changes to the 2011 Medicare Electronic Prescribing (eRx) Incentive Program. The final rule has been published in the Sept. 6, 2011 edition of the Federal Register. The effective date is Oct. 6, 2011. CMS has published a Quick Reference Guide to help providers understand the key provisions and impact of the final rule.
Modification of eRx penalty policy: CMS staff expect that the Final Rule will be published in August. If physicians are unable to meet the current eRx requirement (e-prescribe & report 10 G codes on your Medicare Part B claims by June 30, 2011), they will have an opportunity to apply for an exemption by using a web-based tool to avoid the eRx penalty.
CMS will review the requests and provide exemptions from eRx penalties on a case by case basis.
As many as 209,000 doctors and other health professionals could be eligible to claim exemptions by Oct. 1 to avoid 1% Medicare pay reductions:Medicare to offer more waivers from e-prescribing penalty
June 30, 2011, E-prescribing Incentive Program Deadline
- To avoid a 1-percent penalty in 2012, physicians should report e-prescribing via claims on at least 10 unique Medicare encounters by June 30, 2011 and report at least 25 unique Medicare encounters during the full 2011 year to qualify for the 1-percent 2011 bonus.
- The 2011 Clinician' s Guide to E-prescribing provides information for clinicians interested in learning more about electronic prescribing (e-prescribing), including specific information for office-based clinicians ready to begin implementation of e-prescribing in their practice.
- More information from CMS on e-prescribing.
- Physicians in the Rochester region now have access to a simple, inexpensive option for eprescribing.The Rochester RHIO’s eRX option is CMS certified for the Medicare eprescribing incentive
E-prescribing Requirements Unreasonable
The AMA reports that the Federal Government Accounting Office agrees with physician groups that the 1% eprescribing penalty linked to the CMS requirement to eprescribe for 10 visits between January 1-June 30, 2011 is unreasonable. Read more about the GAO report
Prescribing Data: The American Medical Association created the Physician Data Restriction Program (PDRP) to offer physicians the option to restrict their prescribing data from pharmaceutical sales representatives. The program is free and open to all physicians, regardless of AMA membership.
The FDA is aware that there was a record number of drug shortages in 2010 and the increase in the number of shortages has continued into 2011. This has prompted the agency to ask health care professionals to report such shortages. Physicians also can help by alerting the FDA when information on the agency's drug shortages Web page does not agree with what they are experiencing in their practices. Information on drug product shortages and management can also be found on the American Society of Health-System Pharmacists website
Resources to help physicians ensure patients are taking medication properly: Nearly three out of every four Americans admit they do not take prescribed medication as directed. Physicians now have various resources at their fingertips that can help them improve medication adherence. These resources are part of Script Your Future, a campaign of the National Consumers League and AMA, which offers journal articles, medication lists, fact sheets and guides that physicians can share with patients.
View these resources online.
Learn more about Script Your Future.