CMS E-Prescribing Rule Gets Mixed Reviews

September 6, 2011

CMS’ newly published e-prescribing rule offers several “significant hardship exemptions” to qualified providers. But does it go far enough?

CMS’ newly published 2011 Electronic Prescribing (eRx) Incentive Program final rule offers several “significant hardship exemptions” intended waive 2012 payment reductions of 1 percent for qualified professionals. 

A number of healthcare providers, including those who have already registered to participate in CMS’ EHR incentive program and adopted certified EHR technology, now have until November 1, 2011, to request exemptions.

In the original proposed rule, CMS had said physicians would have until Oct. 1, the American Medical Association noted.

"Changes in the final rule will help doctors and other healthcare providers in their efforts to become successful e-prescribers, ultimately leading to fewer errors and better care for patients," wrote Patrick Conway, CMS chief medical officer and director of the agency's Office of Clinical Standards & Quality, in a blog posting on the agency’s website.

Mary Griskewicz, senior director of health information systems for the Healthcare Information and Management Systems Society (HIMSS), called the final rule a “step in the right direction,” HealthLeaders Media reported.

"The biggest issue was [that] the eligible professionals did not want to have to deal with the payment adjustment for 2012,” said Griskewicz. “We think there's an attempt here to do that. Given the current environment, the providers are still feeling squeezed overall. To have them go through the adjustment in 2012 really wasn't fair.”

Cecil B. Wilson, the AMA’s immediate past president, issued a statement expressing the association’s gratitude as well as its concerns over the changes.

“We are pleased that CMS has provided more flexibility under the exemption categories and that they have extended the deadline for physicians to apply for an exemption until November 1,” said Wilson. “However, we had hoped for even greater flexibility, including an additional reporting period. We remain concerned that physicians will be hit with a penalty and are not being given enough time to comply with the e-prescribing program criteria to avoid this penalty.”

Late last year, a lack of alignment between EHR and e-prescribing programs was a chief complaint among a number of medical associations.

Steven Waldren, director of the Center for Health Information Technology, a division of the American Academy of Family Physicians, told reporters in December that the original proposed e-prescribing rule pulled the rug out from under well-meaning docs.

“A lot of our members have been figuring out what they need, and some have probably made plans relative to that, and the concern is that CMS is changing the rules mid-way through,” said Waldren. “The proposed rule more or less said ‘the penalties start in 2012,’ so that would give you all of 2011 to become an e-prescribing physician to avoid the penalty. Now they’re saying you have to do that in the next six months.”

For more on the e-prescribing rule and incentives, visit CMS’ website.