decisionhealth Newsletters, Part B News - 2013 Issue 6 (June)
How to avoid CMS’ 2% cut by preparing now for the June 30 e-Rx deadline
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Article Overview
This article covers the Medicare e-prescribing payment adjustment process tied to a June 30 deadline and explains the kinds of documentation and reporting evidence providers should have ready. It is aimed at clinicians, billing staff, and coding/compliance professionals who need to understand how e-Rx reporting, exemptions, and CMS review processes affect payment adjustments. The discussion includes general guidance on reporting benchmarks, exclusion criteria, hardship exemptions, and CMS follow-up procedures.
Why This Topic Matters
Missing the required e-prescribing documentation or reporting steps can trigger a Medicare payment adjustment. Understanding the deadline, exemption options, and CMS notification process helps practices reduce the risk of an avoidable cut.
Article Sections
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e-Prescribing
Introduces the payment adjustment issue and the need to verify documentation before the reporting deadline. Discusses the relationship between e-prescribing participation and the broader Medicare adjustment framework.
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Mind your G-codes
Covers the reporting and exemption-related administrative elements associated with the e-prescribing program. Also addresses CMS procedures for recognizing submitted reporting information and handling exemption requests.
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No heads-up from CMS
Summarizes CMS communication practices about reporting status and hardship exemption outcomes. Mentions review options and references to CMS resource materials.
What You Will Learn
- How the e-prescribing payment adjustment timeline is structured
- What types of documentation and reporting evidence are relevant
- Which administrative pathways are associated with hardship exemptions
- How CMS communicates reporting and exemption status
- What follow-up options exist if a provider disputes the adjustment
Who Should Read This
- Physicians and other eligible professionals
- Medical coders and billing staff
- Practice managers
- Compliance and reimbursement staff
- EHR and quality reporting teams
Codes Discussed
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