in HIPAA Headlines by John Brewer

In case you have gotten a bit confused by all of the cliff-dwelling deadlines, here is a reminder for one of them:

June 30 Deadline

June 30, 2013 (yes the end of this month) any provider who submits Medicare Part B Fee for Service (FFS) claims.  Act now to ensure that you avoid the 2.0% payment adjustment (penalty) that would be imposed in 2014.

The 2013 eRx Incentive Program six-month reporting period (January 1, 2013 to June 30, 2013) is the final reporting period available to you if you wish to avoid the 2014 eRx payment adjustment.

If you do not successfully report, a payment adjustment of 2.0% will be applied, and you will receive only 98.0% of your Medicare Part B PFS amount for covered professional services in 2014.  In these days of reduces reimbursements, every percent counts.

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.

The six-month reporting requirements are:

  • 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

There are limited exclusions and hardship exemptions available.  These also must be requested by June 30, 2013.  Some are automatically applied, while others require submission of a G Code on a claim or entry of a hardship exemption request via the CMS Web portal.

Now What?

First, make sure you have e-prescribe in place.  There are many options in the arena, but just like a patient portal, I believe the best option is to use what your EHR recommends.

Second, use it!  Like with meaningful use, there are minimum numbers you need to meet.  Start using e-prescribe ASAP to ensure you don’t get behind the power curve.

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