Avoiding the 2012 Medicare e-prescribing penalties

As the 2012 e-prescribing deadline looms, we continue to receive member questions on how to avoid the penalties by submitting the necessary 10 e-prescriptions per eligible provider for Medicare patients by the June 30th deadline. As practices prepare to accomplish this goal, keep in mind the following: Refills- Do they count?  The Centers for Medicare & Medicaid Services (CMS) recently clarified that refills that are submitted electronically for an eligible patient visit (see the CMS list of eligible cases) in association with a unique face-to-face patient encounter will count for the purposes of the e-prescribing program reporting requirements.  Are there any exclusions related to the 2012 penalties?

  Providers may be excluded from the penalties if one of the following situations applies: A provider was new to Medicare prior to June 30thLess than 10% of your Medicare charges for services rendered Jan. 1- June 30, 2011 are associated with one or more of the eligible patient visitsA provider has billed Medicare for less than 100 instances associated with one or more of the eligible patient visits for services rendered Jan. 1-June 30, 2011Do e-prescriptions for over the counter drugs count?

 CMS recently posted an FAQ stating that e-prescriptions for over the counter drugs that are medically necessary will count for the purposes of the e-prescribing program reporting requirements.  Do we need to enroll to participate and/or report?  No! Simply start reporting the G-code (G8553) in association with an eligible patient visit on CMS 1500 claim forms for Medicare patients. Remember, to avoid the 2012 penalty each eligible provider will need to report at least 10 e-prescriptions for Medicare patients by June 30, 2011 on claims associated with an eligible patient visit.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.