AMA Challenges E-Prescription Penalties

The American Medical Association and 103 state and specialty medical societies have sent a letter to Kathleen Sebelius, secretary for the Department of Health and Human Services, requesting that the Centers for Medicare & Medicaid Services (CMS) change its e-prescribing penalty requirements, which will create a financial burden on physicians, the letter said.

The request was prompted by a change in the e-prescribing policy that CMS published in the 2011 Final Fee Schedule Rule, which introduced a provision requiring a physician to report at least ten instances of using e-prescriptions for Medicare office visits and services between January 1, 2011 through to June 30, 2011. If physicians don't meet these requirements, they will face penalties in 2012 and 2013.

Outlining the difficulties physicians face as they look toward investing in health information technology, the letter, dated December 9, pointed out that CMS publicly stated that physicians will not be able to receive incentives from both the Medicare eRx and the Medicare Electronic Health Record (EHR) programs simultaneously.

Given a choice, many physicians have decided to invest in an EHR, with its comprehensive features, and forego purchasing a standalone e-prescribing system.

"CMS' last minute decision to require e-prescribing in 2011 forces physicians to spend additional financial and administrative resources to purchase, implement [and] train staff on, and use e-prescribing software or applications that most of them will end up discarding when they transition to a complete EHR," authors of the letter wrote.

The letter also said CMS' sudden change to the program requirements does not give physicians enough time to educate themselves on the need for them to take part in the 2011 e-prescribing incentive program to avoid e-prescribing penalties in 2012 and 2013. The letter urges that CMS align these programs in order to alleviate confusion and the imposition of unjustified financial and administrative burdens on physician practices.

The letter recommends that at the very least CMS extend the reporting period so that physicians can report instances of e-prescribing at least ten times during the first ten (not six) months of 2011. The letter also calls for CMS to add more exception categories so that more physicians and other health care professionals will be eligible for an exemption from e-prescribing penalties in 2012 and 2013.