A Quick Guide to e-Prescribing: Collect Your 2% Medicare Bonus in 2010

Since the passage of MIPPA (Medicare Improvements for Patients and Providers Act of 2008), healthcare providers across the country have begun to integrate e-prescribing into their practices. Under the Act, providers who successfully e-prescribe are currently eligible to earn a 2% bonus on their Medicare collections.  Moreover, the e-prescribing incentives are structured in such a way that they will continually decrease over the next few years until they eventually become penalties:

                YEAR

BONUS PENALTY
2010 2% 0%
2011 1% 0%
2012 1% 1%
2013 0.5% 1.5%
2014 & On 0%

                  2%

Nonetheless, many practices are still hesitant to make the transition.  Though most of these providers would agree that e-prescribing is superior to the traditional pen and paper method, many feel that the incentives offered are insignificant compared to the cost (mostly their time) of implementing e-prescribing in their offices.  However, upon closer examination, the requirements for bonus eligibility are not overly stringent or burdensome.    Providers might be able to integrate e-prescribing gradually over an extended period of time and still qualify for the bonuses available under MIPPA.

How to Qualify for a Bonus

Pursuant to the guide released by the Centers for Medicare & Medicaid Services (CMS), healthcare providers must do the following to qualify for the 2% Medicare bonus:

1)      Obtain an eligible e-prescribing system—one that can:

  • Generate a complete medication list incorporating electronic data received from pharmacies and benefit managers.
  • Select medications and transmit prescriptions electronically in accordance with applicable federal standards, and only after warning the prescriber of any possible safety issues associated with the drug order.
  • Provide information related to the availability of lower-cost, therapeutically appropriate alternatives.
  • Provide information on formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan.

2)      Report the appropriate combination of codes on Medicare claims.

  • The physician must report the appropriate combination of CPT codes and special G-codes on Medicare claims—in order to qualify, the physician must report the appropriate G-codes for at least 50% of the cases in which they apply.

3)      E-prescribe enough to qualify for a bonus!

  • The physician must submit just 25 e-prescriptions throughout the entire year!
  • The services the physician provided that can be linked to an e-prescription must make up at least 10% of the physician’s Medicare charges for the year.

With such minimal requirements, the transition to e-prescribing does not have to happen overnight.  Physicians can ease into e-prescribing on their own terms and in their own time, and still take advantage of the bonuses available under MIPPA.

Have Questions? Ask MTBC now or talk to our Representative at (866) 266-6822