E-Prescribing Incentives

E-Prescribing Incentives & its Benefits FAQ

Are you in the look-out for medical incentives that you can qualify? Check this out and take advantage of the new incentive program authorized by the Medicare Improvement for Patients and Providers Act (MIPPA) for eligible professionals who are defined as successful electronic prescribers (E-Prescribers)!

This new incentive program is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 – Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) known as the Physician Quality Reporting Initiative (PQRI).

The e-prescribing incentive is similar to the PQRI incentive wherein reporting periods are one year in length and the incentive is based on the covered professional services furnished by the eligible professional during the reporting year.

E-prescribing is defined as the electronic method of generating prescriptions by using a system that transmits scripts to participating pharmacies electronically.

The E-prescribing incentive amount is based on the Secretary’s estimate (based on claims submitted not later than 2 months after the end of the reporting period) of the allowed charges for all such Physician Fee Schedule (PFS) that covers professional services furnished by the eligible professional during the reporting period.

Beginning last January 1, 2009, providers who use a qualified system to e-prescribe can receive a higher level of reimbursement under Medicare in form of a 2% reimbursement bonus in 2009 and 2010 while this reimbursement bonus will drop to 1% in 2011 and 2012 and to 0.5% in 2013.

As for eligible providers who do not e-prescribe on the given period; they will see a penalty of 1% in their reimbursement starting 2012 and this penalty increases to 1.5% in 2013 and to 2% in 2014 and beyond.

Under the E-Prescribing Incentive Program, covered professional services are those paid under the Medicare Physician Fee Schedule (PFS). When eligible professionals are providing services which are paid under the PFS, those services are eligible to qualify for the E-Prescribing Incentive Program.

An eligible professional shall be treated a successful E-Prescriber for a reporting period if the eligible professional reported the applicable e-prescribing quality measure in at least 50% of the cases in which such measure is reportable by the eligible professional during the reporting year.

In determining whether the eligible professional meets the criteria for successful e-prescribing, the Secretary shall ensure that eligible professionals utilize e-prescribing systems in compliance with standards established for such systems pursuant to the Part D Electronic Prescribing Program under section 1860 D-4 of the SSA.

(Refer to table below)
Year Incentive Penalty
2009 2% None
2010 2% None
2011 1% None
2012 1% 1%
2013 0.5% 1.5%
Beyond None 2%

In order to become a successful e-prescriber and qualify to receive an incentive payment, an eligible professional must use a “qualified” e-prescribing system to report one e-prescribing measure in at least 50% of eligible cases (the cases in which the measure is reportable by the eligible professional) during 2009 and at least 10% of the eligible professional's total Medicare Part B allowed charges for 2009 are from covered services listed in the denominator of the measure.

If determined appropriate by the Secretary, the eligible professional must electronically submit a sufficient number of prescriptions (as determined by the Secretary) under Part D during the reporting period to qualify.

The incentive does not apply to eligible professionals for the reporting period who are under these two situations:

  1. The Medicare allowed charges for all covered professional services for the codes to which the e-prescribing measure applies are less than 10% of the total of the allowed charges under Medicare Part B for all such covered professional services furnished by the eligible professional
  2. The eligible professional does not submit (including both electronically and non-electronically) a sufficient number of prescriptions under Part D even if it was determined appropriate by the Secretary

Adjustment Amounts

This is with respect to covered professional services furnished by an eligible professional during 2012 or any subsequent year. If the eligible professional is not a successful E-Prescriber for the reporting period for the year, the fee schedule amount for such services furnished by such professional during the year shall be reduced by 1.0 percent for 2012, 1.5 percent for 2013, and 2.0 percent for 2014 and each subsequent year.

Hardship Exceptions

The Secretary may, on a case-by-case basis, exempt an eligible professional from the application of the payment adjustment, if the Secretary determines, subject to annual renewal, that compliance with the requirement for being a successful E-Prescriber would result in a significant hardship.

Meditab’s Intelligent Medical Software solution has an integrated EMR with an efficient E-prescribe module that guarantees to qualify you for E-prescribing incentives.

We can help you implement our cost-effective solution in your practice so you can achieve all the benefits of adopting an electronic medical records system and the e-prescribing incentive bonuses provided by MIPPA.

Our IMS’ flexible and comprehensive prescription/e-prescribe module could easily track medication and refill histories.

Complete with drug education integration, dosing, allergy and drug interactions and contra-indication checks—Meditab’s IMS ensures the safety and well being of each of your patients as well as allow you to maintain history of current or past medications; provide drug education; create frequently used individual or group medication templates and transmit prescriptions by print, fax or e-prescribe.

Meditab’s e-Prescription module empowers you to retrieve patient information such as medication histories, eligibility, and formulary information and transmit prescriptions in real-time securely to the pharmacies of your patients' choice. It's easy to use and fully integrated saving you time and maximizing productivity.

Meditab’s EMR meets all the requirements of a qualified e-prescribing system including the following specific tasks:

  • Generate a complete active medication list using electronic data received from applicable pharmacies and pharmacy benefit managers (PBM)
  • Allow providers to select medications and transmit prescriptions electronically, alerting the prescriber of drug-to-drug interactions, allergy concerns, or other unsafe or undesirable situations
  • Provide information on lower cost alternatives and on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan
  • Meet the Part D specifications for messaging that was implemented on April 1, 2009.
  • Improves patient safety and quality of care

    With Meditab’s E-Prescription, prescribers can access critically important information on their patient's current and past prescriptions; hence they are better informed about potential medication issues with their patients and can use this information to improve the delivery of a safer and higher quality healthcare.

  • Reduces time spent on phone calls and call-backs to pharmacies

    Pharmacies will no longer have a reason to call and take up your time when they receive prescriptions electronically. Also, refill requests are received electronically, saving you additional time and effort spent on the phone with pharmacies daily.

  • Automates prescription renewal requests and authorization process

    Gives the prescriber an option to approve or deny automatically sent refill requests from pharmacies solving the age old problem of prescription refill requests from pharmacies and patients.

  • Increases patient convenience and medication compliance

    Prescriptions reach the pharmacies even before patients do, giving pharmacies a chance to serve patients better. Also, since refill requests are automated more compatible medication compliance is maintained.

  • Safer and more efficient process plus savings

    By eliminating paper, phone and fax, electronic prescription routing makes the medications process safer and more efficient, resulting in additional savings in time and money plus eliminating the possibilities of committing medical errors

  • Improves formulary adherence permitting lower costing drug substitutions

    Meditab’s e-Prescription checks with the healthcare formularies at the point of prescribing drugs, thus encouraging generic substitutions and generic first-line therapy choices—resulting in lowered patient costs

  • Decreases the risk of preventable medication errors

    It is estimated that approximately 7,000 deaths occur each year in the United States due to medication errors. These errors are predominately due to hand-writing illegibility, wrong dosing, missed drug interactions or drug or allergy reactions. With our e-Prescription solution your prescriptions are completely error-free; helping to limit liability that may result.

    If you are keen on taking advantage of the E-Prescribing incentives, what are you waiting for? Get your well-deserved incentives and do not hesitate to get the best EHR solution in the market that includes an integrated E-Prescribe module that will allow you to qualify!

For more useful information on the E-Prescription incentives and to stay informed of its latest updates, visit: http://www.cms.hhs.gov/EPrescribing

To check out how Meditab can assist you towards becoming an E-Prescriber, contact us at: meditab@info.com or visit: www.allergyehr.com