E-prescription Medicare Incentive Payments -Key Points

Key Points

1. All providers who submit Medicare Part B Fee for Service Claims will be subject to a payment adjustment in 2012 UNLESS they report 10 e-prescribing events BEFORE June 30, 2011.

2. These 10 e-prescribing events must be reported via claims. They cannot be reported via the Physician Quality Reporting System (PQRS) or any other Medicare reporting system.

3. The only exception is if the provider qualifies for a hardship exemption – see Hardship Exemptions section below for the three hardship reasons.

4. All providers who submit Medicare Part B Fee for Service Claims will be subject to a payment adjustment in 2013 UNLESS they report 25 e-prescribing events BEFORE December 31, 2011.

The Centers for Medicare and Medicaid Services (CMS) are again sponsoring an incentive program to encourage providers to adopt full electronic prescribing capabilities, often described as Informed e-Prescribing. CMS will provide an incentive payment equal to 1% of Medicare Part B Fee for Service (FFS) claims for 2011 for providers who successfully adopt and report on this adoption. Additionally, Medicare has instituted an adjustment (penalty) of 1% on 2012 Part B PFS claims, for providers who have not yet adopted e-prescribing. Lastly, a penalty of 1.5% will be imposed in 2013 for providers who have not yet adopted e-prescribing.