CMS Aligns e-Prescribing Incentive Program with Meaningful Use

On Wednesday, June 1, the Centers for Medicare and Medicaid Services published a proposed rule that would modify its Electronic Prescribing Incentive Program to better align with the meaningful use program. The proposed rule would enable physicians to participate in the meaningful use program and avoid e-prescribing penalties, which include a 1 percent Medicare payment reduction based on Medicare Part B allowed charges.

The proposed rule would:

  • Modify the 2011 electronic prescribing quality measure used for certain reporting periods in calendar year 2011
  • Provide additional significant hardship exemption categories for eligible professionals and group practices to request an exemption during 2011 for the 2012 e-prescribing payment adjustment due to significant hardship
  • Extend the deadline for submitting requests for consideration for the two significant hardship exemption categories for the 2012 e-prescribing payment adjustment that were finalized in the CY 2011 Medicare Physician Fee Schedule final rule

CMS launched the program in 2009. To qualify for e-prescribing incentives this year, providers must e-prescribe 10 orders between January 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 Electronic Prescribing Incentive Program, regardless of whether the eligible provider participates in and earns an incentive under the meaningful use program.

“Stakeholders claim that the requirements under both programs are administratively confusing, cumbersome, and unnecessarily duplicative,” CMS writes in the rule.

The proposed rule will expand the exemptions and the time to report them so providers can avoid the payment penalties. Exemptions will include delaying the deployment of an e-prescribing system due to participation in the meaningful use program. The rule would also revise the description of qualified e-prescribing systems to include certified EHR technology under meaningful use.

Among the program’s 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.

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