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May 22, 2013

Electronic Prescribing (eRx) and the Communications Support Page

The Electronic Prescribing (eRx) Incentive Program is a reporting program that uses a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals (EPs). The program provides an incentive payment to practices with eligible professionals who successfully e-prescribe for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer). EPs who are not successful electronic prescribers on their Medicare Part B services receive a payment adjustment (reduction) to those services. The payment adjustment for calendar year (CY) 2014 will be 2%.

EPs will be exempt from the 2014 payment adjustment (reduction) if one or more of the following payment adjustment exclusion criteria or hardship exemption applies:

  • The EP is a successful electronic prescriber during the 2012 eRx 12-month reporting period (1/1/12 – 12/31/12)
  • The EP submits at least 10 electronic prescriptions and reports G8553 via claims during the 2013 eRx 6-month reporting period 1/1/13 – 6/30/13
  • The EP is not an MD, DO, podiatrist, Nurse Practitioner or Physician Assistant by 6/30/13 based on primary specialty
  • The EP does not have at least 100 Medicare Part B PFS cases containing an applicable encounter code for dates of service 1/1/13 – 6/30/13
  • The EP reports one of the exclusion/hardship exemption HCPCS G-codes on any payable Medicare Part B PFS claim with a date of service during the 6-month eRx reporting period (1/1/13 – 6/30/13)
    • G8642 – EP practices in an area without sufficient high-speed Internet access
    • G8643 – EP practices in an area without sufficient available pharmacies for electronic prescribing
    • G8644 – EP does not have prescribing privileges
  • The EP and members within a group practice participating in eRx GPRO who achieve Meaningful Use under the Medicare or Medicaid EHR Incentive Program during the 12-month eRx reporting period (1/1/12 – 12/31/12) or the 6-month eRx reporting period (1/1/13 – 6/30/13) and attests during the 6-month reporting period (1/1/13 – 6/30/13)
  • The EP and members within a group practice participating in eRx GPRO who demonstrate intent to participate in the Medicare or Medicaid EHR Incentive Program by registering (providing EHR certification ID) during the 6-month reporting period (1/1/13 – 6/30/13) and adopting certified EHR technology
  • The EP requests and CMS approves a hardship exemption via the Physician Quality Reporting Communication Support Page

Communication Support Page

EPs who have not submitted at least one HCPCS G-code on a payable claim between 1/1/13 – 6/30/13 may opt to request a hardship exemption electronically. CMS established the Communication Support Page for EPs and 2013 eRx GPRO primary contacts to submit hardship requests, including those associated with a HCPCS G-code.

To submit a request electronically:

  • Go to the QualityNet page located at https://www.qualitynet.org/portal/server.pt/community/pqri_home/212External Website
  • Select the Communication Support Page link on the left located under “Related Links”
  • Select the Create Hardship Exemption Request link
  • A new window will open to the Quality Reporting Communication Support Page
  • Submit the Requestor Type: Individual EP or Group Practice (participating under GPRO)
  • Once the online form opens, complete all required fields and submit the request.
  • A few points to note:
    • An email address is required when completing this online form. Once the form is submitted, an acknowledgement will be sent via email to the email address indicated confirming receipt of the hardship exemption request.
    • Once the request is evaluated, an email will be sent to the same email address approving or denying the request.
    • Both the acknowledgement email and the approval/denial email will not identify the practitioner for which the request was requested. If an office manager or other office staff submits the request on behalf of multiple EPs, we suggest using the specific EP’s email address for identifying purposes.

Please be sure to submit hardship exemption requests before 6/30/13.

If you have questions, please contact the QualityNet Help Desk at (866) 288-8912 (phone) or Qnetsupport@sdps.org (email).

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