Less than 45 days left to avoid e-prescribing penalties

Earning the e-prescribing incentive for 2011 will not necessarily exempt an eligible professional (EP) or group practice from the one percent penalty starting on Jan. 1, 2012. An EP must successfully e-prescribe for Medicare patients 10 times before June 30, 2011 using claims-based reporting to avoid the payment adjustment in 2012. For 2013, the 1.5 percent penalty is based on whether the EP successfully e-prescribes for 25 Medicare patients during 2011 using claims-based, registry, or EHR reporting methods. Even if the EP attests to being a meaningful user of their EHR in 2011 (a program that includes an e-prescribing requirement), they must still separately submit a minimum of 10 e-prescriptions on claims by the end of June.

Organizations participating in the Group Practice Reporting Option (GPRO) for the e-prescribing incentive program must submit their required number of e-prescriptions by the end of June to avoid the 2012 penalties.

EPs can avoid the 2012 e-prescribing penalty if they:

• Are not physicians (MDs, DOs, or podiatrists), nurse practitioners, or physician assistants as of June 30, 2011 based on their primary taxonomy code in the National Plan and Provider Enumeration System
• Do not have prescribing privileges. Note: they must report (G8644) at least one time on an eligible claim prior to June 30, 2011
• Do not have at least 100 Medicare cases containing an encounter code in the measure denominator
• Have less than 10 percent of their Medicare Part B charges comprised of the codes in the denominator of the measure will not be eligible for the incentive

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 begin_of_the_skype_highlighting            1 888-428-2555      end_of_the_skype_highlighting, Ext. 200.