Electronic prescribing, also known as e-prescribing or "e-Rx," is a prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care. Faxing prescription is not considered a form of e-prescribing. E-prescribing technologies are often part of an EHR system, but they can also be purchased as a stand-alone system, therefore, you do not need to have an Electronic Health Record (EHR) to e-prescribe. Many times you can download e-prescribing programs from the internet right to your desktop. Some e-prescribing programs are free, and some are not. More information on e-prescribing will be posted to this site periodically.
Cashing-In on Electronic Prescribing
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized the Centers for Medicare and Medicaid Services (CMS) to implement a new incentive program for eligible professionals who are successful electronic prescribers as defined by MIPPA. Details of the Electronic Prescribing Incentive Program can be found below.
CMS' Dedicated e-Rx Bonus Incentive Program Web Site
2010 e-Rx Bonus Incentive
The 2010 Electronic Prescribing Incentive Program, including the criteria that CMS will use to determine whether an "eligible professional" is a "successful electronic prescriber," was finalized in the 2010 Medicare Physician Fee Schedule (MPFS) final rule.
According to the rule, the e-prescribing bonus incentive program will provide successful e-prescribers with a 2% bonus incentive payment in 2010. The rule also includes penalties for those who do not successfully e-prescribe by 2012.
Significant Changes to the e-Rx Bonus Incentive Program for 2010
In 2010, physicians must report an e-prescribing code only when a patient visit results in an electronic prescription, and they only need to report this code 25 times during the reporting period. In addition to the current "claims-based" reporting system, prescribers may use qualified registries and qualified electronic health record products to submit data to CMS on the e-prescribing measure for 2010.
How do I know if I am an "eligible professional"?
Eligible professionals include physicians and other recognized practitioners under Medicare who have prescribing authority within their scope of practice. In addition, the bonus incentive is limited to eligible professionals whose estimated allowed charges for the "e-prescribing" procedure codes (aka, denominator codes) are at least 10% of their total Part B Medicare Physician Fee Schedule (MPFS) allowed charges for the reporting period (see the 2010 e-Rx measure specifications).
What patients are eligible for this program?
The Medicare e-Rx bonus incentive program only applies to Medicare patients who are enrolled in the traditional Medicare Part B Fee-For-Service program.
When is the 2010 reporting period?
The 2010 program has one reporting period, which begins on January 1, 2010 and ends on December 31, 2010.
How much is the 2010 incentive?
The 2010 incentive for eligible, successful e-prescribers is 2% of a physicians total allowed charges for services covered under the Part B MPFS. The incentive will be 1% for reporting years 2011 and 2012, and 0.5% for reporting year 2013.
How is a "successful electonic prescriber" defined?
A successful e-prescriber is one who meets the eligibilty requirements above, and generates and reports at least one e-Rx during 25 or more unique patient visit during the reporting period.
How do I report?
Reporting is accomplished by submitting G8553 (reflecting that at least one prescription created during the encounter was generated and transmitted using a qualified e-Rx system) along with the applicable e-Rx denominator codes listed in the 2010 e-Rx measure specifications; however, ophthalmologists are most likely to report the G-code when one of the following procedure codes are reported: 92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, and 99215.
Reporting can be done through claims-based reporting, a qualified registry, or a qualified electronic health record product.
What are the penalites, and when do they start?
Beginning in 2012, if an eligible professional is not a successful e-prescribier for the reporting period, they will face a financial penalty of 1%. In 2013, the penalty will be 1.5%. In 2014, and each year after, the penalty will be 2%.
Help, I still have questions!?
There are a number of resources available on this page, and you may also visit CMS' dedicated web page for the e-Rx bonus incentive program for more detailed information.
For additional assistance, contact Emily L. Graham in the ASCRS Government Relations Department, at 703-591-2220 or egraham@ascrs.org.
2010 e-Rx Measure Specifications
Claims-Based Reporting Principles for the 2010 e-Rx Bonus Incentive Program
2009 e-Rx Bonus Incentive
For the 2009 e-prescribing reporting year, to be a successful e-Prescriber and to receive an incentive payment, an individual eligible professional must report one e-prescribing measure in at least 50% of the cases in which the measure is reportable by the eligible professional during 2009.
There is no sign-up or pre-registration to participate in the E-Prescribing Incentive Program. However, there are certain limitations for participation. First, eligible professionals must have and use a qualified e-prescribing system. Second, at least 10% of eligible professionals' Medicare Part B covered services must be made up of codes that appear in the denominator of the e-prescribing measure.
2009 e-Rx Measure Specifications
Claims-Based Reporting Principles for the 2009 e-Rx Bonus Incentive Program
Sample CMS-1500 Form Completed for the 2009 e-Rx Bonus Incentive Program
From the Washington Watch Weekly:
Phase-In to Mandatory Electronic Prescribing (e-Rx)Included in Public Law 110-275:(H.R. 6331), the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)
As we have been reporting in the ASCRS/ASOA Washington Watch Weekly, the newly enacted law– which prevented the 10.6% reduction on July 1, 2008–also includes several provisions, including the phase-in to mandatory electronic prescribing, which concerned ASCRS. In fact, ASCRS did not endorse this legislation because of these provisions, as well as the funding of the physician payment update provision, which creates a 21% reduction in 2010.
Specifically the phase-in to mandatory electronic prescribing is as follows:
Medicare professionals providing covered services to Medicare beneficiaries and who are successful electronic prescribers will receive an incentive payment of 2% for 2009 and 2010, 1% for 2011 and 2012, and 0.5% for 2013. If eligible physicians do not e-prescribe, penalties of -1% in 2012, -1.5% in 2013, and -2% in 2014 and beyond, are imposed.
Providers who do not have a sufficient volume of qualifying services will be excluded from the program, as will those for whom the Secretary determines that compliance would be a significant hardship (such as for an eligible professional who practices in a rural area without sufficient Internet access). Not later than September 1, 2012, the Government Accounting Office (GAO) will submit a report to Congress on the implementation of the incentives for electronic prescribing established by this section.
In addition, Health and Human Services (HHS) hosted a media briefing on Monday, July 21, 2008, to announce some of its plans for implementing the e-prescribing provisions outlined in MIPPA. According to CMS Administrator Kerry Weems, CMS will host an e-prescribing conference this fall to help physicians and pharmacists connect with the technology they need to make e-prescribing an everyday part of their office transactions. CMS will come out with its plan for making the incentive payments to providers who e-Rx in the 2009 Medicare Physician Fee Schedule (MPFS) ruling later this fall. Weems noted that CMS plans to implement the e-Rx provisions via the Physician Quality Reporting Initiative (PQRI) infrastructure and will issue specific guidance on what constitutes e-prescribing and the extent reporting is necessary to comply.During the question and answer session, Weems explained that CMS is required by law to specify PQRI measures through the rulemaking process, and the e-Rx measures that were listed in the recently released 2009 MPFS proposed rule will need to be "tweaked" in the 2009 MPFS final rule to help CMS connect e-Rx adoption to the bonus incentive. Again, reporting on the use of e-Rx will be carried out by using e-Rx measures, beginning in 2009.An HHS fact sheet on e-Rx is available on the ASCRS and ASOA web sites.
ASCRS' Health Information Technology (HIT) Subcommittee, in conjunction with the ASCRS Practice Management Coordinating Committee, is working with multiple e-Rx software providers to gather information and provide a solid solution to ASCRS and ASOA members that will help them adopt e-Rx technology prior to January 2009. In addition to a webinar, which is planned for the coming weeks, a new web site (www.ascrs.org/e-Rx) dedicated to providing up-to-date information on e-Rx, has been developed. Should you have any questions, please contact Emily L. Graham at 703-591-2220.
CMS' e-Rx Web Site CMS' e-Rx Fact Sheet
The Center for Improving Medication Management Does your local pharmacy accept e-prescriptions? Check here
