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January 10, 2014 By Linda J Sacco Leave a Comment

ePrescribing Incentives Ending

Note: If you received a letter from CMS stating that you are subject to a 2% adjustment (i.e. penalty) on your 2014 Medicare claims for non-participation in the ePrescribing program, but you successfully demonstrated meaningful use in 2012 or the first half of 2013, you should request a review as instructed in the notification an Informal Review no later than February 28, 2014.

Legislation: The Medicare Improvements for Patients and Providers Act (MIPPA)

The ePrescribing incentive program ends after 2014—the last incentives will be earned in 2013 and penalties for non-participation will be incurred through 2014, according to the chart below. Incentives and penalties are calculated as a percentage of estimated total Medicare Part B Fee-For-Service Allowed Charges submitted by the end of February of the following year, according to the following schedule:

Year ePrescribing Bonus Non-ePrescribing Penalty
2009 Bonus 2% – paid Fall 2010
2010 Bonus 2% – paid Fall 2011
2011 Bonus 1% – paid Fall 2012
2012 Bonus 1% – paid Fall 2013 Penalty 1%
2013 Bonus 0.5% Penalty 1.5%
2014 Bonus 0% Penalty 2.0%

2014 ePrescribing Penalties:
To avoid the 2014 ePrescribing penalty, Program-eligible providers had to complete any one of the following actions:

ePrescribed and used the code G-8553 on 25 Medicare encounters (with specified CPT codes) between January and December 2012

ePrescribed and used the code G-8553 on 10 Medicare encounters (with any CPT codes) between January 1 and June 30, 2013

Earned a 2012 Meaningful Use (EHR) Incentive or earned a 2013 Meaningful Use (EHR) Incentive by June 30, 2013

Adopted a certified EHR and registered for the EHR Incentive Program for the first time between January 1 and June 30, 2013

Requested a Hardship Exemption by June 30, 2013

Submitted G-8642 to indicate practicing in a rural area, G-8643 to indicate insufficient pharmacies, or G-8644 to indicate lack of prescribing privileges. (The relevant code only needed to be submitted on one Medicare claim during the reporting period.)

Filed Under: Legislative News, Medical Billing & Coding, Uncategorized

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