Physicians need to electronically transmit 10 prescriptions to the pharmacy by June 30 to avoid a Medicare penalty in 2013. The federal government is serious about digitizing healthcare, and in addition to rewarding physicians who e-prescribe for their Medicare patients, it is penalizing thsoe who are still writing on prescription pads or even computer-faxing scripts (a true electronic prescription goes from the clinician’s computer to the pharmacy’s). This year the Centers for Medicare and Medicaid Services (CMS) began to reduce Medicare reimbursement by 1% for physicians and other prescribers who failed to e-prescribe at least 10 times during the first half of 2011. This adjustment will grow to 1.5% in 2013 and 2% in 2014.
The CMS exempts physicians from the e-prescribing penalty if they qualify for 1 of several hardship exemptions, such as practicing in a rural area that lacks high-speed internet access. However, such physicians must request an exemption no later than June 30 of this year.
In addition, physicians are not subject to the 2013 penalty if they fall into various exclusion categories. Two involve the 50-plus billing codes that must be associated with an e-prescription for it to be counted toward the bonus: physicians will not incur the 2013 penalty if they do not have at least 100 claims for Medicare patients in the first half of 2012 with 1 of these required codes, or if the codes account for less than 10% fo their Medicare allowable charges during that period.