Payment Matters: June 30: Important Deadline for Electronic Prescribing Incentive Program (eRx)

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Two important deadlines for the Electronic Prescribing Incentive Program (eRx or ePrescribing) coincide on June 30, 2012. At stake in both is the application of the "payment adjustment" (penalty) in 2013 – for Eligible Professionals (EPs) who fail to meet the definition of a "successful prescriber" payment for all 2013 covered Part-B eligible charges will be reduced by 1.5%. For EPs who expect to meet the definition of a "successful prescriber" for the 2012 year (thus avoiding the penalty in 2013), June 30 marks the last day counted by CMS to determine whether the minimum criteria (10 electronic prescriptions) have been met. For EPs who know that they will not meet the minimum criteria for the 2012 year, June 30, 2012 is the last day to submit hardship exemption requests.

The eRx program operates on an annual schedule with program incentives (and penalties) applied in a backward-looking fashion and adjusted each year as part of the Physician Fee Schedule (PFS) final rule. In order to avoid a penalty during the 2013 calendar year, EPs must issue a certain minimum number of electronic prescriptions by June 30, 2012. To avoid the penalty during 2013 that number is remaining unchanged – EPs must report at least 10 electronic prescriptions between January 1, 2012 and June 30, 2012.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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