California physicians are reporting that the Medicare payments they are receiving in 2012 have been reduced for a failure to prescribe enough electronically in 2011—despite the fact that these physicians have filed hardship applications to the Centers for Medicare & Medicaid Services (CMS). CMS responded to CMA inquiries that it was not able to process all hardship applications prior to January 1, although the agency says it has since approved or denied all of those exemption requests. This means that CMS has levied a 1 percent penalty for what it considers “noncompliant physicians.”
CMA is working with CMS to build clarity over whether penalties will apply to physician reimbursement rates going forward, and to ease confusion over the process in the future. For now, there is no official appeals process for the e-prescribing penalty program. However, CMS has expressed a willingness to work with individual physicians on concerns with the payment adjustments.
CMS encourages physicians who think they are receiving the e-prescribing penalty in error to contact its help desk. The QualityNet Help Desk can be reached by phone Monday through Friday, 7 am to 7 pm CST at (866) 288-8912 or by email at firstname.lastname@example.org.
Avoid the 2013 penalty
On March 1, the agency reopened its hardship requests from physicians looking to avoid the 2013 e-prescribing penalty, which will grow to 1.5 percent. Physicians seeking waivers will have until June 30 to file exemption requests. A request for a feedback report, and an application for a hardship exemption, can be filed online by clicking on the Communications Support Page.