American Association of Physicians of Indian Origin

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Medicare deadline for e-Prescribing exemption is November 1st, 2011

Oct 27, 2011


Providers would be subjected to a 1% penalty in 2012 if:

·         They have not started to e-prescribe

·         *AND* reported the code G8553 on at least 10 patient encounters in the office between Jan 1st and June 30th, 2011

·         *AND* filed the concerned claim by July 31st, 2011.

*The following would be automatically exempt:

·         For all claims with dates of service between Jan 1st to June 30th, 2011 and filed by July 31st, 2011 if your total allowed medicare charges for office visits is LESS THAN 10% of all Medicare charges for the same period

·         Less than 100 of your claims for Medicare Part B patient services contain visit and service codes that fall within the ePrescribing measure specifications for dates of service between January 1, 2011 and June 30, 2011.

·         You are not an MD, DO, podiatrist, nurse practitioner, or physician assistant as of June 30, 2011.
You do not have prescribing privileges and you reported the G-code, G8644, at least one time on a Medicare Part B claim prior to June 30, 2011.

*Medicare plans to notify you if you would be subjected to the penalty but you should not wait for the letter to determine whether you are subject to the penalty since Highmark Medicare Services has expressed concerns about whether these letters will arrive before November 1.*

*Additional exemptions possible BUT NEED TO APPLY by Nov. 1st, 2011*

Possible Reasons:

·         You are registered to participate in the Medicare or Medicaid electronic health record (EHR) Incentive Program and you adopted certified EHR technology by October 1, 2011, and did so prior to requesting an exemption.

·         You are unable to electronically prescribe due to local, state or federal law or regulation, (CMS clarified that physicians who mainly prescribe narcotics but due to certain limitations cannot submit these prescriptions electronically can apply for this exemption category).

·         Limited prescribing (you do not prescribe on a regular basis).

·         There were too few opportunities for you to report the ePrescribing measure due to limitations of the measure’s denominator (you do e-prescribe but your electronic prescriptions are not related to qualifying visits/services).

*This would apply only if you do e-prescribe but not during the office patient visit*.

This is how you apply:

*Go to the above link and fill out and submit electronically.*



Here is a collection of some resources in this regard. The same documents are attached as well.

AMA - Act now to avoid the Medicare ePrescribing penalty that starts January 1, 2012

AMA - FAQ ePrescribing Update: Penalties, Incentives and Controlled Substances Webinar: September 14, 2011

CMS: Electronic Prescribing (eRx) Incentive Program

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