Physicians who practice part-time in a nursing home or another long-term care facility and have limited electronic prescribing (e-prescribing) opportunities will not be penalized for their failure to adopt e-prescribing in their practices, according to the final rule for the 2011 Medicare Electronic Prescribing Incentive Program. The Centers for Medicare and Medicaid Services (CMS) issued the rule in early September.

The e-prescribing incentive program was authorized by the Medicare Improvements for Patients and Providers Act of 2008. Through the program, physicians who use a qualified e-prescribing system are eligible for an additional 1% in Medicare Part B payments in 2011 and 2012, and a 0.5% increase in 2013. Providers who fail to meet minimum e-prescribing requirements will receive a 1% cut in Medicare reimbursements in 2012, a 1.5% cut in 2013 and a 2% cut in 2014.

According to the final rule, physicians are exempt from the payment adjustments if they:

• See very few patients.
• Practice in rural areas without sufficient high-speed Internet access.
• Have insufficient access to pharmacies.
• Have had limited prescribing activity during a 6-month time frame.
• Reside in an area where regulations hinder e-prescribing.
• Are registered to participate in the Medicare or Medicaid Electronic Health Record Incentive Program.