AMA claims CMS too quick on the draw with 2012 penalties for e-Rx non-compliance

CHICAGO– Are non-compliance penalties for Medicare e-prescribing starting before the physician community can reasonably make the transition? The American Medical Association and other groups say yes and are objecting to CMS’ plan to implement fines starting next year.

 AMA claims CMS too quick on the draw with 2012 penalties for e-Rx non-compliance

CHCAGO– Are non-compliance penalties for Medicare e-prescribing starting before the physician community can reasonably make the transition? The American Medical Association and other groups say yes and are objecting to CMS’ plan to implement fines starting next year.

As part of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), the penalties will be a percentage reduction in Medicare physician fee schedule payments equal to 1 percent in 2012, 1.5 percent in 2013, and 2 percent in 2014 and beyond. Providers able to show hardship – such as rural locations without high-speed Internet – will be exempt from penalties.

The AMA argues that MIPPA doesn’t allow enough time to apply for an exemption to the 2012 penalties. “Physicians are working hard to adopt e-prescribing and other health IT and should not be unfairly penalized for practice patterns that do not fit neatly within the current, limited exemption process,” AMA immediate past president Cecil B. Wilson, MD, stated in a letter to CMS.

Though it’s no secret that the majority of prescriptions are still being written on paper, industry analysts say that the migration to e-prescribing is well underway with the meaningful use initiative under the American Recovery and Reinvestment Act, which came out the year after MIPPA. Under the tenets of meaningful use, health systems and physician groups that adopt electronic health records will have e-prescribing as part of their systems. Yet because providers have until 2013 for EHRs, a 2012 penalty deadline for e-prescribing could justifiably be seen as premature, observers say.

“E-prescribing apps are widely available and inexpensive, but it doesn’t make sense to bolt one on apart from a larger EHR system just to be in compliance,” said Tom Giannulli, MD, chief medical information officer for San Mateo, Calif-based Epocrates. “Although it came later, meaningful use should supersede MIPPA’s 2012 e-prescribing deadline because once there is widespread adoption of EHRs, e-prescribing will be part of that.”

Because the EHR-electronic prescribing overlap is in full evidence, it seems natural that both sides will reach some sort of middle ground on the penalty issue, reasoned Mitch Morris, MD, national healthcare IT practice leader for New York-based Deloitte Center for Health Solutions.

“CMS’ goal is to accelerate e-prescribing in the most expeditious manner and having financial penalties gets people’s attention,” he said. “I expect that there will be a normal ‘back and forth’ dialogue that will get us to where we need to be, even if it is not as fast as CMS would like.”

Janice Jacobs, director of regulatory compliance for Chadds Ford, Pa-based IMA Consulting, is convinced that CMS is trying to cut physicians some slack on the issue.

“They seem to want to treat providers fairly and overall their goal is to not really burden providers that aren’t ready or who don’t do a lot of prescribing,” she said. “They are going after the bigger institutions, which should be better positioned to have e-prescribing systems in place.”