mountains for livewire

Title Words
E-News for Office Staff  June 1, 2011

CMS logo 
Colorado Medical Society Health Care Financing Division

PHONE: (720) 858-6321

FAX: (720) 859-7509
EHR incentives: Attestation open, checks being sent



Meaningful use attestation for the Medicare Electronic Health Record (EHR) Incentive Program is now open to eligible physicians and hospitals through the Centers for the Medicare and Medicaid Services (CMS) website.   


CMS began issuing checks  for Meaningful Use incentives last month.  


Colorado primary care providers are encouraged to use Colorado Regional Extension Center's (CO-REC) services, provided at no cost, to help guide them through the attestation process.


Learn more about whether you qualify for incentives, and what you need to do to receive funds, by visiting the CORHIO/CO-REC website.  

PQRS / eRx reports now available

The 2009 Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program Reporting Experience report is now available.


The 2009 Reporting Experience summarizes the experience of eligible professionals in the 2009 Physician Quality Reporting System and eRx Incentive Program as well as trends in the program over time, including early results from 2010.


The 2009 Reporting Experience is available:

Fact Sheet: Medicare Physician Fee Schedule

This fact sheet is designed to provide education on the Medicare Physician Fee Schedule (PFS) including physician services, therapy

services, Medicare PFS payment rates, and the Medicare PFS rates formula.   


To place your order, visit 


Scroll to "Related Links Inside CMS," and select "MLN Product Ordering Page."

Recent payer newsletters






5010 National Testing Day

The Jan. 1, 2012 Version 5010 compliance date is fast approaching. All HIPAA-covered entities should be taking steps now to get ready, including conducting external testing to ensure timely compliance.

To assist in this effort, CMS, in conjunction with the Medicare FFS Program, announces two National 5010 Testing Days to be held June 15 and August 24, 2011.

National 5010 Testing Days are an opportunity for trading partners to come together and test compliance efforts that are already underway with the added benefit of real-time help desk support and direct and immediate access to MACs.

According to TrailBlazer, trading partners will need to register for the June 15, 2011, testing day by completing the National 5010 Testing Day Registration form on the 5010 Information Web page.

Note that among the changes you will see with 5010 is that the data reporting requirements for transactions differ from the current transactions. These changes may require the collection of additional data or reporting data in a different format. For example, with Version 5010, the billing provider address can no longer be reported as a P.O. Box or lockbox address.

Check out this 5010 Checklist to learn more about these and other steps you could be taking now to make sure you'll be ready.
Exemptions to 2012 eRx penalty

As we have explained in previous LiveWires and ASAPs, Colorado Medical Society, AMA and the rest of organized medicine has had great concerns about the Centers for Medicare and Medicaid Services imposing ePrescribing penalties in 2012 based on 2011 activity.


Last week, CMS responded in a positive manner and issued a proposed rule that makes significant changes to the eRx penalty program by adding more exemption categories so that physicians are not unfairly penalized.  


Physicians are still required to e-prescribe using a qualifying eRx system and report the G8553 code on at least 10 Medicare Part B claims from Jan. 1, 2011 through June 30, 2011 to avoid the 2012 eRx penalty.


However, under the proposed rule, physicians also will have an opportunity to attest through an on-line web portal that they should be eligible for one of the following exemptions:

  • Physician's practice is located in a  rural area without high speed internet access
  • Physician's practice is located in an  area without sufficient available pharmacies for electronic prescribing  
  • Physician is registered to participate  in the Medicare or Medicaid EHR Incentive Program and has adopted certified  EHR technology
  • Physician is unable to electronically  prescribe due to local, State, or Federal law or Regulation (e.g., prescribes  controlled substances)
  • Physician infrequently prescribes  (e.g., prescribe fewer than 10 prescriptions between January 1, 2011 -June 30,  2011)
  • There are insufficient opportunities  to report the e-prescribing measure due to program limitations   

Physicians will have to apply for an exemption from the 2012 eRx penalty via the web-portal tool by Oct. 1, 2011.  


The link to the proposed rule is available here (scroll to the bottom of the page under "Related Links Outside of CMS").

The proposed rule will be published in the Federal Register on June 1, 2011. The comment period will close on July 25, 2011. 

Primary care incentive program 
(From TrailBlazer Health)

Eligible primary care practitioners who furnish primary care services from Jan. 1, 2011, through Dec. 31, 2015 will receive a quarterly incentive payment equal to 10 percent of the amount actually paid each quarter for those services.


The incentive payment is calculated based on the amount paid for the services, not on the Medicare allowed amount for the service.

Practitioners meeting the following two criteria are eligible for the incentive:

  • Identified by their Medicare enrollment records as being physicians with a primary specialty designation of: Family medicine (08); Internal medicine (11); Pediatrics (37); or Geriatrics (38).  
  • Or non-physician practitioners with a specialty designation of: Nurse Practitioner (50); Certified Clinical Nurse Specialist (89); or Physician Assistant (97).
Learn more and find links to helpful MLN Matters articles here.
About Us
The Colorado Medical Society is the largest organization of physicians in the state of Colorado. This newsletter is published by the CMS Health Care Financing Division, which works with physicians, practice managers and other office staff to help practices remain viable and thrive. If you have questions about practice viability, please visit our website or email