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June 24, 2011


Washington Letter
June 24, 2011
Newsletter of the American Thoracic Society's Washington Office

1150 18th Street NW
Suite 300
Washington, D.C. 20036
Telephone:(202) 296-9770


June 30th eRx Participation Deadline Quickly Approaching

Medicare providers have until June 30, 2011 to meet the Electronic Prescribing (eRx) participation deadline. 

The eRx Incentive Program is a program designed for eligible professionals (EPs) who are successful electronic prescribers, as defined by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The eRx incentive payment for both 2011 and 2012 is 1.0 percent of total estimated allowed charges. For 2013, the incentive payment will be reduced to 0.5 percent. Beginning in 2012, there will be a penalty for not participating in eRx. The penalty will be a reduction in Physician Fee Schedule payments by 1.0 percent in 2012, 1.5 percent in 2013 and 2.0 percent in 2014.
In order to avoid a penalty in 2012, eligible professionals and group practices must have 10 unique eRx events between January 1 and June 30, 2011. To avoid a penalty in 2013, eligible physicians must have 25 unique eRx events in calendar year 2011. CMS has not yet announced whether eRx filings in 2012 will count towards avoiding penalties in 2013. Due to this ambiguity, the ATS strongly recommends that eligible professionals begin filing as soon as possible.  

EPs do not need to participate in the Physician Quality Research System (PQRS) to qualify for the eRx program. In order to qualify, EPs must have and use a qualified eRx system and report on his or her adoption and use of the eRx system. The EP must also meet the criteria for successful electronic prescriber specified by the CMS for a particular reporting period. Finally, at least 10 percent of a successful electronic prescriber’s Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure. For pulmonary, the denominator codes are new and established office visits, 99201-99205, 99211-99215.
Reporting eRx participation only involves a single quality data code: 
G8553: At least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx system. (G codes were different for 2010)
eRx Exemption Codes
There is possibility for hardship exemptions from the eRx penalty, provided that the physician falls under one of the following G codes:
G8642: The eligible professional practices in a rural area without sufficient high-speed Internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.
G8643: The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.
G8644: The eligible professional does not have prescribing privileges.

The link to the eRx Incentive Program CMS web page is: www.cms.gov/erxincentive/

If you have any questions on eRx or PQRS, you can contact the CMS QualityNet Help Desk by either calling them at 1-866-288-8912 (open 7:00 AM – 7:00 PM CST) or emailing them at Qnetsupport@sdps.org .


ATS Testifies on Respiratory Health Concerns in Iraq and Afghanistan Veterans

This week, ATS member Matthew King, MD testified before the Senate Department of Defense Appropriations Subcommittee about the growing body of research documenting respiratory illnesses in returning Iraq and Afghanistan veterans.  In his comments Dr. King noted a future publication of a case series that documents bronchiolitis in nearly 50 returning veterans.  Dr. King outlined a number of respiratory assaults faced by service men and women and made recommendation on how the Department of Defense and the Department of Veterans Affairs should respond to health needs of these returning veterans.

FDA Issues Graphic Label Images

This week, the Food and Drug Administration released the new warning labels that will appear on every pack of cigarettes and every tobacco advertisement. Starting September 22, 2012 all tobacco products and tobacco advertisements must have the new graphic warning images prominently displayed on the front and back of cigarette packages.  At least 50 percent of the package will be covered with warning information.  Additionally, at least 20 percent of advertisements will be covered with warning images.  Adds less than 12 [square?] inches will not be required to contain the graphic images but will require posting of the 1-800 QUIT NOW line. 

The FDA estimates that these warning labels will reduce the number of smokers by 213,000 by 2013.  The ATS and many partner organizations worked for years for Congress to give FDA the authority to regulate tobacco products.  The graphic images released by FDA today are just one of the many actions the agency has taken under its new authority to regulate tobacco products, granted by the 2009 Family Smoking Prevention and Tobacco Control Act.

The new graphic warning labels can be viewed on the FDA website:



AMA Adopts ATS Resolution on End of Life Planning

At the American Medical Association House of Delegates meeting this week, the AMA adopted a resolution introduced by the ATS that supports Medicare coverage for voluntary end of life planning.  The ATS introduced the resolution after the Centers for Medicare and Medicaid Services (CMS), which administers the Medicare program, finalized a rule covering end of life discussions only to immediately rescind the policy after a public backlash that equated Medicare coverage of voluntary end of life discussions to “death panels.”


HHS Introduces New National Prevention Strategy

On June 16, Health and Human Services Secretary Kathleen Sebelius unveiled the Department’s new National Prevention Strategy, which aims to increase the number of Americans who are healthy at every stage of life. The strategy, authorized under the Affordable Care Act, was drafted by the National Prevention Council, composed of representatives from 17 relevant federal agencies, and through consultation from outside experts and the public.

The National Prevention Strategy has 4 strategic directions, which include: 1) building healthy and safe community environments; 2) expanding quality preventive services in both clinical and community settings; 3) empowering people to make healthy choices; and 4) eliminating health disparities. The strategy aims to change the U.S. health system from a focus on sickness and disease to a focus on prevention and wellness. The strategy outlines the following 7 priority areas to meet the strategic directions:

  • Tobacco-free living
  • Preventing drug abuse and excessive alcohol use
  • Healthy eating
  • Active living
  • Injury and violence-free living
  • Reproductive and sexual health
  • Mental and emotional wellbeing

Finally, the strategy sets out key indicators in the named strategic direction areas and additionally, causes of death. The strategy sets a goal to lower the number of deaths from lower respiratory disease from 40.8 (2007) to 35.1 within ten years. Under “building healthy and safe community environments”, the goal is to reduce the number of days the air quality index exceeds 100 from 11 currently to 10 and  to reduce the amount of toxic pollutants released into the environment by 10 percent within 10 years. The National Prevention Strategy can be viewed at: http://www.healthcare.gov/center/councils/nphpphc/strategy/report.pdf


NIGMS Names Acting Director

NIH Director Francis Collins, MD, PhD has named Judith Greenberg, PhD, as the new acting director of the National Institute of General Medical Science (NIGMS).  Dr. Greenberg will temporarily replace departing institute director Jeremy Berg, PhD during the search for a permanent director. Dr. Berg is moving to the University of Pittsburgh.

Dr. Greenberg, a developmental biologist, has directed the NIGMS Division of Genetics and Developmental Biology since 1988. She served as acting director of NIGMS previously, from May 2002 to November 2003. She has a strong interest in bioethics and currently serves on the NIH Bioethics Task Force. Additionally, Dr. Greenberg is the principal leader of the NIH Director’s Pioneer Award program and of the NIH Director’s New Innovator Award program Dr. Greenberg will take her position at NIGMS in early July. NIGMS supports basic research in cell biology, biophysics, genetics, developmental biology, pharmacology, physiology, biological chemistry, bioinformatics and computational biology.


Framework for COPD Prevention Released by CDC

In June, the Centers for Disease Control and Prevention (CDC) released the Framework for COPD Prevention document.  This document, a product of a COPD stakeholder meeting hosted by the CDC in the spring of 2010,  includes a number of policy recommends for stakeholders address COPD in the U.S.ATS members played a key role in drafting the document and the ATS continues to partner with the CDC and other federal agencies to bring attention to COPD in the U.S. 

The document can be found at the CDC website at:




The Washington Letter is written by the American Thoracic Society government relations office and emailed to all ATS members living in the United States. The letter keeps clinicians, scientists, and patients abreast of legislative, judicial, and regulatory issues in pulmonary, critical care, and sleep medicine. Each week's edition is archived on the ATS Web site, www.thoracic.org. If you have any questions or one more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.