Incentive
Payment For E-Prescription
and EHRs
The
Stimulus Bill
American
Recovery and Reinvestment
Act (ARRA)
These
payments are in addition
to bonus payments under
Physician Quality Reporting
Initiative (PQRI).
Table
1: Incentive
Payment For E-Prescription
and EHRs
Year
When Payments
Begin
|
Percent
of Medicare
Part B Schedule
Fee For e-prescription
|
Total
Payments Receive
for Meaningful
HER use
|
2009
|
+2%
|
|
2010
|
+2%
|
|
2011
|
+1%
|
$44,000
over 5 years
|
2012
|
+1%
|
$44,000
over 5 years
|
2013
|
+.5%
|
$39,000
over 4 years
|
2014
|
|
$24,000
over 3 years
|
Note: If
physician is receiving
HER incentive payments,
cannot concurrently
receive the e-prescribing
bonus as well.
Table
2: Penalties
for not adopting
E-Prescribing and
EHRs
Year
When Penalties
Begin
|
Percent
of Medicare
Part B Schedule
Fee For Not e-prescription
|
Percent
of Medicare
Part B Schedule
Fees for no
HER
|
2012
|
-1%
|
|
2013
|
-1.5%
|
|
2014
|
-2%
|
|
2015
|
|
-1%
|
2016
|
|
-2%
|
2017
|
|
-3%
|
2018
and beyond
|
|
Could
be increased
upto 5%
|
You
do not have to register
to participate in this
incentive program. Eligible
professional who successfully
report the e-prescribing
measure in 2009 may be
eligible to receive an
incentive payment equal
to 2% of all their Medicare
Part B (Free-for-service,
or FFS) allowed charges
for services furnished
during the reporting
period.
The
2009 Reporting Period
is January 1, 2009
through December 31,
2009 This measure can
only be reported using
the Medicare claims
process.
Table3: What
is a Qualified E-prescribing
system?
A
qualified system is
an e-prescribing system
or program that is
able to perform the
following task:
- Generate
a complete active
medication list using
electronic data received
from applicable pharmacies
and pharmacies benefit
manage (PBM), if
available.
- Allows
eligible professionals
to select medications,
print prescription
electronic and conducts
a ll alerts. Alerts
include automated
prompts that offer
information on the
drug being prescribed
and warn the prescriber
of possible undesirable
or unsafe situations
such as potentially
inappropriate dose
or route of administration
of the drug, drug-drug
interaction, allergy
concerned or warninigs/cautions.
- Providers
information on lower
cost therapeutically
appropriate alternatives,
if any. For 2009,
a system that can
receive tiered formulary
information, if available,
from thw PBM would
satisfy this requirement.
- Providers
information on formulary
or tiered formulary
medications, patient
eligibility and authorization
requirements received
electronically from
the patient drug
plan (if available)
- In
addition to the system
functionalities mentioned
above, the system
or program should
meet the Part D specifications
for messaging that
will be implemented
on April 1, 2009.
For more information
about the new Part
D requirements, please
see http://www.regulations.gov and
search from Part
D prescription
Table
4: E-Prescription
Measure Denominator
Codes
The
following CPT or
HCPCS G-codes
are included in the
denominator of the
e-prescribing measure:
90801,90802,
90803, 90804, 90805,
90806, 90807, 90808,
90809, 92002, 92004,
02012, 92014, 96150,
96151, 99152, 99201,
99203, 99204, 99205,
99211, 99212, 99213,
99214, 99215, 99241,
99243, 99243, 99244,
G0101, G0108, G0109