CMS Issues Final Rule on E-Prescribing

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: September 06, 2011 WASHINGTON — Doctors now have an extra month to apply for a hardship waiver to avoid being penalized for not adopting electronic prescribing in their practices, according to a final rule issued by the Centers for Medicare and Medicaid Services (CMS).

Physicians who use a qualified e-prescribing system are eligible for an additional 1% in Medicare Part B payments in 2011 and 2012, and a 0.5% increase in 2013. Providers who fail to complete at least 10 paperless prescriptions using a qualified e-prescribing system between Jan. 1 and June 30, 2011, will receive a 1% cut in Medicare reimbursements in 2012, a 1.5% cut in 2013, and a 2% cut in 2014.

In a proposed rule from May, CMS said doctors who are unable to e-prescribe should apply for a “hardship exemption” before Oct. 1. In the final rule issued Sept. 1, CMS announced doctors now have until Nov. 1 to apply for an exemption.

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Florida Lifts Prescription Drug State of Emergency

via Florida Tribune 8-29-11

Just days before a new drug database is set to start operation, the state of Florida announced that it was lifting the statewide public health emergency it declared due to Florida’s prescription drug crisis.

State officials first declared the emergency back in early July and then swept through clinics across the state for inspections that yielded in the seizure of hundreds of thousands of prescription drugs.

“While the statewide public health declaration may no longer be in effect, the efforts of the Florida Department of Health, law enforcement partners and other state agencies remain strong,” said Gov. Rick Scott in a statement.

Scott had set up a task force to go after pain clinics back in March. Scott initially was opposed to keeping intact the proposed drug database – which is meant to track prescriptions issued by doctors for drugs such as OxyContin, Valium and Xanax.

But Scott, lawmakers and Attorney General Pam Bondi reached a compromise that kept the database which is scheduled to become operational this Thursday. A bill passed this past session also requires physicians to submit their prescription information within seven days.

Dr. Frank Farmer, the Department of Health secretary, also announced along with lifting the state of emergency he was also lifting a moratorium on a part of HB 7095 that had been put on hold.

Two months ago Farmer put on hold a requirement that as many as 50,000 Florida-licensed physicians use counterfeit-resistant prescription pads. The move was taken in the wake of phone calls from patients and doctors saying that pharmacies around the state had begun to refuse to fill prescriptions for controlled substances because the prescriptions were not written on the approved pads.

“Allowing the practitioners who are approved to prescribe controlled substances more time to order the prescription pads was necessary to ensure public safety over the long term,” Farmer said. “Now is the time to start using them.”

Avoiding the 2012 eRx Payment Adjustment


An eligible professional can avoid the 2012 eRx Payment Adjustment if he or she: Is not a physician (MD, DO, or podiatrist), Nurse Practitioner, or Physician Assistant as of June 30, 2011, based on primary taxonomy code in the National Plan and Provider Enumeration System (NPPES); Does not have prescribing privileges and reports G-code G8644 (defined as not having prescribing privileges) at least one time on an eligible claim prior to June 30, 2011; Does not have at least 100 cases containing an encounter code in the measure’s denominator; Becomes a successful electronic prescriber (submits required number of electronic prescriptions (10 for individual) via claims and reports this to CMS before June 30, 2011); or Claims a hardship as described below. A group practice that is participating in eRx GPRO I or GPRO II during 2011: MUST become a successful electronic prescriber (submit required number of electronic prescriptions via claims before June 30, 2011); (Depending on the group’s size, the group practice must report the eRx measure for 75-2,500 unique eRx events via claims for patients in the denominator of the measure). If an eligible professional or selected group practice wishes to request an exemption to the eRx Incentive Program and the payment adjustment, there are two “hardship codes” that can be reported via claims if one of the following situations apply: G8642 – The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act. G8643 – The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

For additional information, please visit the “How to Get Started” and “Payment Adjustment Information” sections at on the CMS website.

New Prescription Pad Laws Effective July 1, 2011

Effective July 1, 2011, physicians and pharmacies (should) have been notified by the State of Florida of a new law requiring the use of counterfeit-proof script pads for controlled substances. Orders on a generic prescription pad will not be honored by the retail pharmacies. For additional information about counterfeit-proof pads and vendors follow the links below:

CMS Changes E-Prescribing Penalty Program

Physicians who are using a qualified e-prescribing program on only 25 Medicare claims over the course of the entire year, can claim a 1% bonus (2% in 2010). The only have to add a single code to the claim to qualify ( G8553). 2011 is the last year physicians can switch to e-prescribing without generating a penalty. In 2012, physicians filing at least the minimum 25 Medicare claims will receive a 1% bonus, but those not doing so will incur a 1% penalty! In 2013, the incentive drops to 0.5%, and the penalty increases to 1.5%. In 2014, and beyond, there will be no incentive, but the penalty will rise to 2% and remain there. Physicians can obtain a FREE e-prescribing system by signing up at