Do you want to avoid the 1% penalty from Medicare in 2012?
GOOD NEWS! – As of September 6, 2011, CMS will give physicians a second chance to use an expanded list of exemptions to avoid a pay decrease of 1% in 2012 for not meeting e-prescribing requirements earlier this year.
Q & A
Did I meet the e-prescribing requirements for 2011?
Physicians will not be penalized or won’t need to apply for exemption if:
- Successfully reported prescribing medicine electronically for their patients during eligible services at least 10 times between January 1 and June 30 in 2011
- OR -
- Reported one of the initial hardship exemptions created by CMS: Those working in areas without high-speed Internet access or pharmacies accepting e-prescriptions.
If I did not meet the requirements above, what do I have to do to avoid the 1% penalty for 2012?
Physicians can try to qualify for one of the significant hardship waivers offered by CMS for the electronic prescribing incentive program by November 1st, 2011. The new exemptions are:
- Registered to participate in the Medicare or Medicaid electronic medical record incentive programs and adopted certified EMR technology.
- Been unable to prescribe electronically due to local, state or federal law or regulation.
- Had limited prescribing activity.
- Had insufficient numbers of eligible patient visits during which to report the e-prescribing measure.
Can HealthTec Software help with any of the new exemptions to avoid the 1% penalty next year?
Yes, HealthTec Software can help. We can assist you to apply for the 1st exemption, with registration and adoption of a certified EMR technology. HealthTec Trilogy is a fully certified EMR system.
Does that mean I have to start using your EMR before November 1st or sometime this year?
No, you do not have to actually start utilizing HealthTec Trilogy EMR before November 1st or even this year to meet the 1st exemption. We can explain how.
Where can I find more information, how to apply for the exemption, the link to the registration for the EMR incentives and information on your EMR?
Resources:
AMA Summary of Changes to Electronic Prescribing (eRx) Incentive Program:
http://www.ama-assn.org/amednews/2011/09/12/gvl10912.htm
CMS Changes to the Electronic Prescribing (eRx) Incentive Program:
http://www.gpo.gov/fdsys/pkg/FR-2011-09-06/pdf/2011-22629.pdf
CMS Exemption Waiver Submission site:
www.qualitynet.org/portal/server.pt/community/communications_support_system/234
CMS EMR Incentives Registration/Attestation site:
https://ehrincentives.cms.gov/hitech/login.action
5010 Preparedness
HealthTec Software is aware many of you have received notices from payers and different associations to
make sure your practice is prepared for “5010.”
“5010” specifically relates to the new electronic claim format, which will be implemented on January 1,
2012 and the move from ICD-9 to ICD-10 codes, which is scheduled to be implemented on October 1,
2013.
The first major step, which is scheduled to occur January 1, 2012, is the change from the current 4010
electronic claim to the 5010 format. The new format includes over 800 new data elements and will be able
to accommodate the new ICD-10 codes. Many of these new data elements though are situational and
will not impact most claims. These changes are being added to address issues that some providers had
submitting the current 4010 format.
We are aware that you are being asked to begin testing the new format and to contact your software
vendor.
First, HealthTec in conjunction with our clearinghouse partners has been testing for months. Unless you
submit direct to a payer, you DO NOT need to test. If you submit via a clearinghouse, the
clearinghouse is the submitter. We have verified that our partner clearinghouses (HT Claim Services,
ClaimRemedi, Availity, ClaimLogic and Health-e-Web (formerly ET&T)) have tested and are ready for the implementation of
5010.
If you are using a NON-supported clearinghouse to submit claim electronically, you will want to contact
the clearinghouse and determine if they can “cross-walk” your current 4010 format to the new 5010
format. HealthTec DOES NOT support direct submission to payers.
Despite the dire warnings about the “5010” deadline, many practices today are still submitting print image
or NSF formats that are translated into the 4010 format upon receipt.
We have tested our current HTPM system and our new Trilogy application with our supported
clearinghouse destinations. If you are on a Support and Update Subscription and use one of our
Supported Clearinghouse Partners and it is determined any updates or patches are required you will
receive these prior to the January 1st implementation deadline.
If you are on an earlier version of software other than HTPM 5b or HealthTec Trilogy and you are not
using a supported destination you may want to consider changing your clearinghouse now. HealthTec
offers a variety of services including a free option. You will also need to update your software to the
5b version or Trilogy.