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December 8, 2009:

E-prescribing is defined as a prescriber’s ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point of care. It is an important element in improving patient quality of care.

The MMA or Medicare Modernization Act of 2003 and the July 2006 report from the Institute of Medicine helped build awareness of the role e-prescribing plays in enhancing patient safety. Development of standards that will facilitate eprescribing is a key action item in the government’s plan to implement and expedite the adoption of electronic health records as well as to build a national electronic health information infrastructure.

Under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), a new and separate incentive program was implemented for eligible professionals who successfully e-prescribe. This new incentive is separate and in addition to the quality reporting incentive program. An eligible professional does not need to participate in PQRI in order to participate in the E-prescribing Incentive Program. There is no registration or sign-up required; however, there are certain criteria that must be met in order to qualify for participation. The EP must have and use a qualified e-prescribing system.

For 2010 an individual EP must report the E-prescribing measure for at least 25 unique electronic prescribing events in which the measure is reportable by the EP to be considered a successful electronic prescriber for the 2010 E-prescribing Incentive Program and qualify to earn a 2 percent incentive payment.

Effective January 1, 2009, EPs can participate by reporting on their adoption and use of an e-prescribing system by submitting information on one e-prescribing measure on their Part B claims. If successful, the EP would qualify for a 2 percent incentive payment for 2009.

Effective in 2010, a group practice (200 or more eligible professionals) may also qualify to earn an incentive payment equal to 2 percent of the group practice's total estimated Medicare Part B Physician Fee Schedule allowed charges for covered professional services furnished during the 2010 reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS.

This criteria includes, group practices must submit a self-nomination letter to CMS, requesting to participate in the 2010 PQRI group practice reporting option by Nov. 15, 2009. Once selected the e-prescribing measures must be reported through one of the following: claims, a qualified registry, or a qualified EHR product. In addition, group practices must report the 2010 e-prescribing measure at least 2,500 times during the reporting period to be considered a successful electronic prescriber and qualify for the 2 percent incentive payment.

For more information on group e-prescribing, go to www.cms.hhs.gov/PQRI/22_Group_Practice_Reporting_Option.asp#TopOfPage

Nichole VanHorn, CPC
Clinical Technical Editor


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