MIPPA’s ePrescription Incentives/Penalties Deadline Looms!

The deadline for qualifying for the ePrescription (eRx) incentive monies and for determining whether or not penalties will be levied in 2012 arrives at the end of June! Is your practice ready? And if not, is there still time to get ready?

Eligible practices/doctors can begin reporting to the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Sciences for the eRx measure any time through December 31, 2011 to be incentive-eligible. However, in order to avoid penalties in 2012, they must report prior to the June 30, 2011 deadline.

A practice/doctor doesn’t need to sign up or pre-register in order to participate in the incentive program and receive 1% extra on Medicare receivables—s/he only needs to have and use a qualified eRx system and report to CMS on its adoption and use of it. A qualified eRx—or an EMR with eRx functionality such as Clinic Service’s C-Suite—must possess the capabilities to access, store, and incorporate electronic data about a patient’s active medications and insurance coverage. Ultimately, the eRx should make the prescription-filling process more efficient and affordable by cutting down on the time and cost of dealing with paper prescriptions and by working with a patient’s insurance coverage to reduce their out-of-pocket cost as well. For more detailed requirements, please see our new article “eRx: An Overview of Electronic Prescription Incentives, Penalties, and Exemption.”

Whether or not a doctor plans to participate in the eRx incentive program, theMedicare Improvements for Patients and Providers Act of 2008 (MIPPA) allows the CMS to penalize those who do not submit their reports of eRx by June 30, and the penalties will begin in 2012. To impose these penalties, the CMS will withhold 1%, 1.5%, and 2% of a practice’s receivables from their Medicare receivables in 2012, 2013, and 2014 respectively. The only way a doctor can avoid penalties is if they live in a rural area without access to high-speed Internet or lack sufficient available pharmacies for e-prescribing, or if they are not eligible to prescribe at all by June 30. Each of these scenarios has a “hardship code” associated with it that a doctor must report to CMS in order to qualify for exemption.

Remember, a practice must report on the status of their adoption of eRx standards before June 30 to receive incentives and avoid penalties. A physician/practice can report to CMS in one of three ways: through their claims, a CMS-selected registry, or through a CMS-selected EMR. To learn more about these reporting methods, see the new article mentioned above.

*New 2011 eRx Proposed Rule*

The CMS proposed another rule on June 1, 2011 that would add additional exemption categories and extend the deadline for submitting requests for the two existing hardship categories. Health professionals have until July 25, 2011 to submit comments to this new rule. See the Federal Register Vol. 76, No. 105 pdf June 1, 2011 for the proposed rule and details on how to comment.

*If you have any additional questions about MIPPA and eRx, click here, or contact Clinic Service VP Michael Kuehn at (720) 248-3444 or mkuehn@clinicservice.com to get started today.

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About Clinic Service: Founded in 1974 by James Grow as a medical billing company, Clinic Service has never strayed from its mission: To Maximize the Profit for Physicians and Medical Practices. We believe our market leadership and growth in medical billing and supporting services like EMR and EHR is a result of our focus on customer experience and our internal culture. The Clinic Service culture is founded on learning and personal growth.

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