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Medicare's E-Prescribing Incentive Program

  • Date: 2009/03/16
  • Dallas Alford
  • Synopsis : The Medicare e-prescribing incentive is a new initiative authorized under the Medicare Improvements for Patients and Providers Act.

Main Document

The Medicare e-prescribing incentive is a new initiative authorized under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The program started January 1, 2009 and offers incentives for eligible providers that meet certain criteria.

The Medicare e-prescribing incentive is a new initiative authorized under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

The program started January 1, 2009 and offers incentives for eligible providers that meet certain criteria. The e-prescribing Incentive Program is currently based on one e-prescribing quality measure that is currently included in the Physician Quality Reporting Initiative (PQRI). Beginning in 2009 the e-prescribing quality measure will be removed from the PQRI and it will become the quality measure used in the e-Prescribing Incentive Program.

For 2009 the e-prescribing incentive amounts will be 2% of the total estimated allowed charges for professional services covered by Medicare Part B and provided by an eligible professional during the reporting period. To be a successful e-prescriber, you must report the e-prescribing quality measure through your Medicare Part B claims on at least 50% of applicable cases during the reporting year.

To participate in the e-prescribing incentive program you must use a "qualified" e-prescribing system. There are essentially two types of systems: a system for e-prescribing only (a "stand alone" system), or an electronic health record (EHR) system with e-prescribing capabilities.

To get the incentive in 2009, you have to report on the e-prescribing quality measure with one of the three appropriate G codes on more than 50% of applicable cases within your practice.

Eligible providers that are not "successful e-prescriber's" by 2012 will be subject to a differential payment (penalty) beginning in 2012.

To learn more about Medicare's e-prescribing program, visit the following URL: www.cms.hhs.gov/ERXIncentive/.

It's certainly worth any practice that bills a substantial amount of Medicare to enroll in the e-prescribing program in order to reap the financial benefits and in essence, improve efficiency within your practice.




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