Avoid eRx penalties: CMS announces new exemption categories

On May 26 the Center for Medicare and Medicaid Services (CMS) responded to AMA concerns about the e-prescribing penalty program and issued a proposed rule that makes significant changes to it by adding more exemption categories. These changes will assure that physicians are not unfairly penalized for failing to meet the requirements under the 2012 e-prescribing penalty program.

The American Medical Association (AMA) has had many concerns with the e-prescribing penalty from CMS. AMA President Cecil Wilson, MD, has discussed these concerns on several occasions with Donald Berwick, MD, the CMS administrator. AMA staff also has continually stressed to senior CMS officials that there was an urgent need to modify the policy.

Physicians are still required to e-prescribe using a qualifying e-prescribing system and report the G8553 code on at least 10 Medicare Part B claims from Jan. 1, 2011, through June 30, 2011, to avoid the 2012 e-prescribing penalty.

However, to avoid the 2012 e-prescribing penalty, physicians now will have an opportunity to attest through an on-line web portal that they are eligible for one of the following penalty exemptions:

Physician's practice is located in a rural area without high speed internet access


Physician's practice is located in an area without sufficient available pharmacies for electronic prescribing


Physician is registered to participate in the Medicare or Medicaid EHR Incentive Program and has adopted certified EHR technology


Physician is unable to electronically prescribe due to local, State, or Federal law or Regulation (e.g., prescribes controlled substances)


Physician infrequently prescribes (e.g., prescribe fewer than 10 prescriptions between January 1, 2011 –June 30, 2011)


There are insufficient opportunities to report the e-prescribing measure due to program limitations (e.g., surgeons)

Physicians will have to apply for an exemption from the 2012 e-prescribing penalty via the web-portal tool by Oct. 1.


Read more on the CMS website.

View the proposed rule.

See a statement from the AMA on the e-prescribing policy modifications.

The proposed rule will be published in the Federal Register on June 1, 2011. The comment period will close on July 25, 2011.

The AMA will review the proposed rule in more detail once it is formally published.