Medicare can be so confusing. I'm not even talking about Part D and the donut hole (yummy, I love donuts). The e-prescribing incentives can get a bit confusing, especially if you were used to the e-prescribing quality measure that was included in the Physician Quality Reporting Initiative (PQRI) before Jan 1, 2009. To provide some clarity on this topic, let me do a bit of a "Q&A" with Medicare about the e-prescribing incentives. All this content is directly from the HHS.gov website.
Here's the first question:
"What requirements/qualifications are needed to successfully participate in the new Electronic Prescribing (e-prescribing) Incentive Program?"Answer:
To be a successful e-prescriber for the 2009 e-prescribing Incentive Program, an eligible professional must have adopted a qualified e-prescribing system that employs standards adopted by the Secretary for Part D by virtue of the 2003 Medicare Modernization Act (MMA) and is capable of ALL of the following functions:Are you ready for a second Q&A? How about this: I'll try to cover 1 key Q&A topic each day over the next few weeks.
- Generating a complete active medication list incorporating electronic data received from applicable pharmacy drug plan(s) if available
- Selecting medications, printing prescriptions, electronically transmitting prescriptions, and conducting all alerts (defined below)
- Providing information related to lower cost, therapeutically appropriate alternatives (if any) (the availability of an e-prescribing system to receive tiered formulary information, if available, would meet this requirement for 2009)
Two additional criteria must also be met for the incentive program to be a successful e-prescriber and qualify for the incentive: 1) Medicare charges for the e-prescribing measure codes (delineated in the denominator of the measure specification found here) comprise at least 10% of total Medicare Part B allowed charges; and 2) at least 50% of all Medicare Part B patient encounters (denominator-eligible cases) for the e-prescribing measure must be reported during the 2009 reporting period.
- Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available