The Centers for Medicare and Medicaid Services (CMS) plans to modify its electronic prescribing incentives schedule to better align with its electronic health record incentive program so physicians can both avoid e-prescribing penalties and also participate in CMS’ EHR Incentive Program.
E-prescribing is a requirement for meaningful use of electronic health records (EHRs) to qualify for incentives.
CMS released the proposed rule on May 27 and it will be published in the June 1 Federal Register. The public will be able to comment for 60 days.
In 2009, CMS started the E-prescribing (eRx) Incentive Program. To qualify for eRx incentives this year, providers must e-prescribe 10 orders between Jan. 1 and June 30, 2011.
Medicare providers cannot earn an incentive under both incentive programs for the same year. However, providers will be subject to an e-prescribing payment adjustment if they do not meet the requirements under the eRx Incentive Program, regardless of whether the eligible provider participates in and earns an incentive under EHR incentive program.
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“Stakeholders claim that the requirements under both programs are administratively confusing, cumbersome, and unnecessarily duplicative,” the proposed rule said.
The proposed rule will expand the exemptions and the time to report them so providers can avoid the payment penalties. Exemptions will include putting off deploying an e-prescribing system because they are participating in the EHR incentive program. The rule would also revise the description of qualified e-prescribing systems to include certified EHR technology under meaningful use.
Among the requirements, e-prescribing systems must be able to generate and transmit prescriptions and active medication list; check for drug-drug interactions; and check whether drugs are in a health plan’s formulary or preferred drug list.
The American Medical Association welcomed the flexibility of the proposed rule and the elimination of unreasonable penalties. “Physicians who are working to adopt e-prescribing and other health IT should not be unfairly penalized for practice patterns that do not fit neatly within the current, limited exemption process,” said Dr. Cecil Wilson, AMA president, in a statement..
In February, the Government Accountability Office had said that CMS should reconcile the inconsistencies between the two programs.
The EHR program provides incentives from 2011 to 2016 and introduces penalties beginning in 2015, while the e-prescribing program provides incentives from 2009 to 2013 and provides for penalties from 2012 to 2014, when the program ends. Both programs require providers to adopt and use technology that can perform similar electronic prescribing-related activities.
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The EHR program requires providers to adopt and use EHR systems that are certified to meet criteria which include electronic prescribing-related capabilities, while the e-prescribing program does not have a certification requirement.]
According to the e-prescribing program, a physician or group practice in 2011 can qualify for an incentive equal to 1 percent of its total estimated Medicare Part B physician fee schedule allowed charges for covered professional services.
In 2012, a payment adjustment will begin for those who do not e-prescribe and increase each year through 2014. Specifically, those physicians will receive 99 percent of the fee in 2012, 98.5 percent in 2013 and 98 percent in 2014.
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