2014 eRx Payment Adjustment Deadline Approaches

June 30th Deadline Date on 2014 eRx

The Electronic Prescribing (eRx) Incentive Program is a CMS reporting program that uses a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals. The program is open to both eligible professionals (EPs) and group practices under the Group Practice Reporting Option (GPRO). June 30, 2013 is the next deadline approaching to successfully report before payment adjustments will occur for professional services covered under Medicare Part B’s Physician Fee Schedule (PFS). January 1, 2013 to June 30, 2013 is the final 6-month reporting period available to avoid the 2014 eRx payment adjustment. Payment adjustments of 2% will be applied for those that do not successfully report by the deadline. The following is guidance from the Centers for Medicare & Medicaid Services, eHealth initiative.

Avoiding the 2014 eRx Payment Adjustment 
Individual EPs and eRx GPRO participants who were not successful electronic prescribers in 2012 can avoid 2014 eRx payment adjustment by meeting specified reporting requirements between January 1, 2013 and June 30, 2013. Below are the6-month reporting requirements:

  • Individual EPs – 10 eRx events via claims
  • eRx GPRO of 2-24 EPs – 75 eRx events via claims
  • eRx GPRO of 25-99 EPs – 625 eRx events via claims
  • eRx GPRO of 100+ EPs – 2,500 eRx events via claims

Exclusions and Hardships Exemptions
Exclusions from the 2014 eRx payment adjustment only apply to certain individual EPs and group practices, and CMS will automatically exclude those individual EPs and group practices who meet the criteriaCMS may exempt individual eligible professionals and group practices participating in eRx GPRO from the 2014 eRx payment adjustment if it is determined that compliance with the requirements for becoming a successful electronic prescriber would result in a significant hardship. Requests for hardship exemptions must be submitted by June 30, 2013. More information on exclusion criteria and hardship exemption categories can be found on the Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.

Resources from CMS

Questions about eRx?
The Help Desk is available Monday through Friday from 7am-7pm CT. If you have questions regarding the eRx Incentive Program, eRx payment adjustments, or need assistance submitting a hardship exemption request:

  • Call – QualityNet Help Desk at 866-288-8912 (TTY 1-877-715-6222)
  • Email – qnetsupport@sdps.org .