Receiving Your ePrescribing Penalty in Error?
If your Medicare payments are being reduced by the Centers for Medicare & Medicaid (CMS) ePrescribing penalty, the agency may reconsider cases whose providers feel they were penalized in error. New regulations went into effect this year.
The 1 percent reduction resulting from the penalty for physicians not ePrescribing prompted the American Medical Association (AMA) to request a second look at the law, the organization says. The loop hole not only applies to errors, but to providers who applied for a hardship exemption.
The AMA says common scenarios allowing you to avoid the penalty include:
- You ePrescribed in 2011, but HCPCS Level II code G8533 Participation by a physician or other clinician in systematic clinical database registry that includes consensus-endorsed quality measures was removed from the claims you submitted to Medicare. (For example, your billing vendor or clearinghouse mistakenly removed the code.) You must have documentation of your ePrescribing activity.
- You reported the wrong G code on your claims. (For instance, you used a 2009 ePrescribing code instead of the 2011 code.) You must have documentation of your ePrescribing activity.
- Your hardship exemption request was denied because you included your group National Provider Identifier (NPI) rather than your individual NPI.
- You filed a hardship exemption request, but did not receive a response from CMS.
Other hardships may qualify you to receive an exemption to the penalty. Call CMS’ Quality Net Help Desk at (866) 288-8912 or send an email to present your case.