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Overview

Electronic Prescribing (eRx) Incentive Program

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"What's New" (recently posted items) for the eRx Incentive Program

Background. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for eligible professionals (EPs) who are successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI). Eligible professionals do not need to participate in PQRI to participate in the Electronic Prescribing (eRx) Incentive Program.

For each program year, CMS implements the eRx Incentive Program through an annual rulemaking process published in the Federal Register. Information regarding the relevant statutes and regulations can be found by clicking on the "Statutes/Regulations" section page to the left.

A list of professionals eligible to participate in the eRx Incentive Program is available by clicking on the "Eligible Professionals" link at left.

No Sign Up or Pre-Registration

There is no sign-up or pre-registration to for individual EPs to participate in the eRx Incentive Program. However, there are certain limitations for who can qualify for an eRx incentive payment. First, an EP must have and use a qualified eRx system and report on his or her adoption and use of the eRx system. Second, the EP must meet the criteria for successful electronic prescriber specified by CMS for a particular reporting period. Finally, at least 10% of a successful electronic prescriber's Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure.

Note: The eRx Incentive Program requirements and measure specifications for the current program year may be different from the eRx Incentive Program requirements and measure specifications for a prior year. EPs are responsible for ensuring that they are using the eRx incentive documents for the correct program year.

2010 eRx Incentive Program

To participate in the 2010 eRx Incentive program, individual EPs may choose to report on their adoption and use of a qualified eRx system by submitting information on one eRx measure: (1) to CMS on their Medicare part B claims, (2) to a qualified registry, or (3) to CMS via a qualified electronic health record (EHR) product. Additional information on the registry-based or EHR-based reporting mechanism for the eRx Incentive Program is available by clicking on the "Alternative Reporting Mechanisms" link at left.

To be considered a successful electronic prescriber for the 2010 eRx Incentive Program and potentially qualify to earn a 2.0% incentive payment for the 2010 eRx Incentive Program, an individual EP must report the eRx measure for at least 25 unique electronic prescribing events in which the measure is reportable by the EP during 2010.

Beginning with the 2010 eRx Incentive Program, a group practice may also potentially qualify to earn an eRx incentive payment equal to 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the 2010 eRx reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS. Click on the "Group Practice Reporting Option" link at left to learn more about this reporting option and to obtain instructions on how a group practice can sign up to participate in this reporting option.

2009 eRx Incentive Program

To participate in the 2009 eRx Incentive Program, individual EPs must report on their adoption and use of a qualified eRx system by submitting claims information on one eRx measure on their Medicare Part B claims. To be considered a successful electronic prescriber for 2009 and potentially qualify to earn a 2.0% incentive payment for the 2009 eRx Incentive Program, an individual EP must report the eRx measure in at least 50% of the cases in which the measure is reportable by the EP during 2009.

Information on the eRx measure can be found by clicking on the "eRx Measure" section page to the left.

Additional resources to help EPs become successful electronic prescribers can be found by clicking on the "Educational Resources" section page to the left.

To find out who to contact with questions regarding the eRx Incentive Program, click on the "Help Desk Support" link at left.

 

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Part D eRx Standards

All eRx FAQs

 

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Page Last Modified: 11/18/2009 2:21:00 PM
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