Do you understand the Medicare e-Prescribing Incentive Program? Don't get this confused with the incentives outlined in ARRA about HITECH. Sorry, let me clarify: The Medicare e-Prescribing Incentive Program is not the same as the recent incentives outlined in the Health Information Technology (HITECH) provisions within the American Recovery and Reinvestment Act (ARRA).
The Medicare e-Prescribing Incentive Program began January 1, 2009 and provides incentives for eligible healthcare professionals who are "successful e-prescribers". We'll define that later. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for eligible professionals who are successful electronic prescribers (e-Prescribers) as defined by MIPPA. For 2009, e-prescribing incentive amounts will be 2% of the total estimated allowed charges for professional services covered by Medicare Part B and furnished by an eligible professional during the reporting period (one calendar year). 2% may not seem like much, but it can add up quickly.
Previously, there used to be an e-prescribing quality measure that was included in the Physician Quality Reporting Initiative (PQRI). Now, e-prescribing is no longer included in PQRI and it is the quality measure used in the E-prescribing Incentive Program.
One question that often gets asked about the Medicare e-Prescribing Incentive Program is this: "What defines a "qualified' e-prescribing system?" If you're using an EHR that has some type of e-prescribing capability, are you using a "qualified" e-prescribing system?
According to Medicare, there are two types of e-prescribing systems:
- 1) a system for e-prescribing only (a “stand-alone” system), or
- 2) an electronic health record (EHR) system with e-prescribing functionality.
- Generate a complete medication list that incorporates data from pharmacies and benefit managers (if available)
- Select medications, transmit prescriptions electronically using the applicable standards, and warn the prescriber of possible undesirable or unsafe situations
- Provide information on lower-cost, therapeutically-appropriate alternatives (for 2009, tiered formulary information, if available, meets this requirement)
- Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan