Significant Hardship Exemptions for the Purposes of the

70.1 – Significant Hardship Exemptions for the Purposes of the Payment Adjustments – Individual Eligible Professionals and Group Practices (Rev. 10, Issued: 07-27-12, Effective: 10-29-12, Implementation: 10-29-12) For the 2012 payment adjustment, an eligible professional or group practice may request a significant hardship exemption via the Quality Reporting Communication Support Page if any of the following situations apply: • The eligible professional practices in a rural area without sufficient high speed internet access (also reportable via reporting G-code G8642 on claims) 21 • The eligible professional practices in an area without sufficient available pharmacies for eRx (also reportable via reporting G-code G8643on claims) • Eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Programs and adopt Certified EHR Technology • Inability to electronically prescribe due to local, state, or federal law or regulation • Limited prescribing activity • Insufficient opportunities to report the eRx measure due to limitations of the measure’s denominator For the 2012 payment adjustment, the initial deadline for submitting a request for the first two significant hardship exemption categories via submission of the appropriate G-code on at least one claim was the end of the 2012-6-month payment adjustment reporting period (that is, June 30, 2011). For group practices that self-nominated to participate in the 2011 GPRO, group practices were required to request a significant hardship exemption for these first two significant hardship exemption categories at the time that they self-nominated to participate in either GPRO I or II for 2011. However, with the addition of the last four significant hardship exemption categories to the 2012 payment adjustment in September 2011, the deadline for individual eligible professionals to submit a request for a significant hardship exemption under all significant hardship exemption categories via the Quality Reporting Communication Support Page was extended to November 1, 2011. Similarly, group practices that participated in the eRx GPRO for 2011 were given until November 1, 2011 to submit a letter requesting a significant hardship exemption under all significant hardship exemption categories. For the 2013 and 2014 payment adjustments, an eligible professional or group practice may request a significant hardship exemption via the Quality Reporting Communication Support Page if any of the following situations apply: • The eligible professional or group practice practices in a rural area without sufficient high speed internet access (also reportable via reporting G-code G8642 on claims) • The eligible professional or group practice practices in an area without sufficient available pharmacies for eRx (also reportable via reporting G-code G8643on claims) • The eligible professional or group practice is unable to electronically prescribe due to local, state, or Federal law or regulation • The eligible professional who prescribes fewer than 100 prescriptions during a 6- month, payment adjustment reporting period 22 The deadline for eligible professionals and group practices to report the first two hardships via the respective G-code on a claim is June 30, 2012 for the 2013 payment adjustment and June 30, 2013 for the 2014 payment adjustment. For eligible professionals, the deadline for submitting a request for a significant hardship exemption to the 2013 and 2014 payment adjustment via the Quality Reporting Communication Support Page is June 30, 2012 and June 30, 2013 respectively. Group practices wishing to request a significant hardship exemption to the 2013 and 2014 payment adjustment must indicate its request for a significant hardship exemption due to one of the above significant hardship exemption categories in its self-nomination letter to participate in the eRx GPRO for the 2012 and/or 2013 respective program year. Therefore, the deadline for group practices to submit a significant hardship exemption letter via its self-nomination letter is the date in which the self-nomination letter is due for the respective program year.