tci Medicare Compliance & Reimbursement - 2011 Issue 4
Incentive Payments: Want to Show Your Exemption From the E-Prescribing Penalty? Use New G Codes, CMS Says
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Article Overview
This article covers CMS guidance on the e-prescribing incentive program and the related payment adjustment timeline, with emphasis on who may be exempt and how exemption status is communicated to a Medicare contractor. It is relevant to physicians, nonphysician practitioners, practice managers, and coding/billing staff tracking Medicare Part B reporting requirements and CMS administrative guidance. The article also discusses general participation timing, qualifying hardship categories, and the relationship between e-prescribing activity and broader electronic health record efforts.
Why This Topic Matters
It helps readers understand which providers may face the e-prescribing payment adjustment, who may qualify for an exemption, and the general reporting framework CMS described for avoiding penalties.
Article Sections
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CMS e-prescribing incentive and payment adjustment overview
Introduces the program, the timing of payment adjustments, and the broader Medicare context for reporting participation.
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How to avoid the adjustment
Summarizes the general categories of professionals and circumstances discussed by CMS as potentially exempt from the adjustment.
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Hardship exemption
Covers the hardship-based exemption categories CMS described and the related reporting approach to notify the contractor.
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How to proceed when you're awaiting meaningful use
Addresses the relationship between e-prescribing activity and later electronic reporting goals, as discussed in the CMS forum call.
What You Will Learn
- How CMS framed the e-prescribing incentive and adjustment program
- Which broad provider groups may qualify for exemption consideration
- What general hardship situations CMS discussed
- How the article relates e-prescribing activity to later meaningful use efforts
- What type of reporting mechanism CMS said is used to communicate exemption status
Who Should Read This
- Physicians
- Nurse practitioners
- Physician assistants
- Practice managers
- Medical coders
- Billing staff
- Compliance staff
Codes Discussed
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