ALERT TO PHYSICIANS WHO HAVE RECEIVED LETTERS RE. E-PRESCRIBE NON-COMPLIANCE
CMS sent out letters this week to physicians that they believed had not sent in at least 10 e-prescriptions on Medicare Part B patients by June 30, 2011. Consequently, these physicians will be docked 1% of their Medicare Part B payments in 2012.
Unfortunately, there are physicians appearing on the list that have submitted the required 10 e-prescriptions by June 30th and their names erroneously appear. This has created “widespread panic” among practices that attempted to comply with the e-prescribe regulations and are now not sure what to do. To compound the problem, the Payment Adjustment Feedback Report that was supposed to be available prior to November 1st to verify the billing information by practice is now not going to be released until November or December. So there is no way to check directly at this point.
Therefore, practices are urged to take these steps:
- Have their billing department pull remits/EOBs and establish the list of patients that had prescriptions submitted between January 1, 2011 – June 30, 2011 that had the N365 code appear in the G88553 box on the form. This will verify that the claim was captured for e-prescribe. Note: the only prescriptions that will be tabulated are Medicare Part B fee-for-service patients and do not include Medicare Advantage patients.
- Have the physicians apply for an e-prescribe exemption through the CMS website. Here is the information on how to access and tips about registering. Note, there is not a category for exemption that covers this situation, so the practice will need to check off another category and then list their explanation in the Justification for Hardship Exemption box:
Please keep in mind that the physician must file by November 1, 2011, so they should start working on it now. It is a simple one-page form that is done online, but must be done by the provider. Keep in mind:
Above is the link to CMS to apply for an exemption. The form is very short. All the physician needs to do is enter his/her name, address, NPI, TIN and with 250 words or less state why he/she should receive an exemption. The physician needs to select which exemption he/she wishes to seek and give the justification. At the bottom of the page, the physician will click the “I accept” button and then hit “Submit.”
A few things to note:
- Under the section marked “Requestor Relationship” they need to select “Health Care Provider.” Any other selection will kick out the request, since the physician is supposed to complete the request for him or herself.
- All fields marked with a red asterisk need to be filled out or an error message will pop up and the submission can’t go forward.
Once the physician completes the submission, he/she should receive an e-mail within a few minutes telling them that their submission was received. It usually takes about 30 days to process, but the e-mail acknowledging it is almost instantaneous. If they do not receive an e-mail within about 10 minutes (check the Spam folder!) have them resubmit.