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Eligible Professionals: eRX Participation Affects 2015 Medicare EHR Payment Adjustment

December 23, 2013: From the CMS Newsletter
Didn’t participate in eRx in 2012 or 2013? Here’s what you need to know.
If you were not a successful electronic prescriber under the 2012 or 2013 eRx, or Electronic Prescribing Incentive Program:

  • You will be subject to a payment adjustment in 2014.
  • The final 2.0% eRx payment adjustment will be applied during the 2014 calendar year.

That means you will only receive 98% of your Medicare Part B PFS amount for covered professional service in 2014. CMS will notify you if you are subject to the 2014 eRx payment adjustment.
Medicare EHR Payment Adjustments
If you are eligible to participate in the Medicare EHR Incentive Program:

  • If you have not successfully demonstrated meaningful use, payment adjustments will be applied beginning January 1, 2015.
  • The adjustment is determined by the reporting period in a prior year.

Additional eRx Impact for Medicare EHR providers with a 2015 Payment Adjustment
If you were not subject to the 2014 eRx payment adjustment:

  • Your 2015 EHR payment adjustment will be 1%.

If you were subject to the eRx adjustment:

  • Your 2015 EHR payment adjustment will be 2%.

To Avoid Medicare Payment Adjustments
If you successfully participated in the Medicaid or Medicare EHR Incentive Program and demonstrate meaningful use before 2015 or if you are eligible for a hardship exemption, you may be able to avoid the payment adjustment.
Note: If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid.
Learn more by reviewing the Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals.
Request an eRx Informal Review
You can request an informal review if you were notified that you will be subject to the 2014 eRx payment adjustment. Informal review requests can be submitted to [email protected] through February 28, 2014.
For More Information
Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

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