CMS releases final eRx rule

The Centers for Medicare & Medicaid Services (CMS) on Wednesday announced changes to the Medicare Electronic Prescribing (eRx) Incentive Program for calendar year 2011.

[See also: AMA, others sound alarm on proposed e-Rx penalty changes]

CMS received public comments raising concerns that the Medicare eRx Incentive program did not better align with the Medicare or Medicaid EHR Incentive Program also about the need for additional significant hardship exemption categories.

Among individuals and organizations submitting comments was the American Medical Association.

[See also: AMA to HHS: Medicare e-Rx penalty policy 'unreasonable']


“While we appreciate the modifications CMS presented in the proposed rule, they don’t go far enough,” AMA immediate past president Cecil B. Wilson, MD, said in his letter to CMS last month. “More changes are needed, including establishing an additional reporting period in 2012 and not applying penalties until 2013.”

CMS is making the following changes in the final rule:

Modify the existing 2011 electronic prescribing measure to address uncertainties related to the technological requirements of the Medicare eRx Incentive Program: The existing 2011 electronic prescribing measure is revised to indicate that a qualified electronic prescribing system includes certified EHR technology as defined at 42 CFR 495.4 and 45 CFR 170.102.


Provide additional significant hardship exemption categories for purposes of the 2012 payment adjustment: The eligible professional or group practice must demonstrate that one of these situations applies to the respective practice:

  • Eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Programs and adopt certified EHR technology;
  • Inability to electronically prescribe due to local, state or federal law or regulation;
  • Limited prescribing activity; or
  • Insufficient opportunities to report the electronic prescribing measure.

Extend the deadline for requesting significant hardship exemptions to Nov. 1, 2011. This extended reporting deadline would apply to the two significant hardship exemptions established in the calendar year 2011 MPFS Final Rule as well as the additional significant hardship exemption categories above.