Health care providers participating in both eRx and EHR incentive programs can now breathe easy. Under a new rule, the Centers for Medicare and Medicaid Services (CMS) has proposed modification of its electronic prescription (eRx) incentive program thereby better aligning it with its EHR incentive plan.

Providers participating in the EHR incentive program had been concerned about being penalized for missing e-prescribing system deadlines under the eRx incentive program which was launched earlier. As the EHR program also requires providers to adopt an e-prescribing system and fulfill related functions, there was an overlap between the two programs, which has been straightened out by the new rule.

Such providers will now have more time to report their e-prescribing quality measures under the modified eRx incentive program. Also, a certified EHR technology will be accepted as a qualified e-prescribing system thereby exempting such providers from penalties under the new rule.

The proposed rule, however, states that Medicare eligible professionals (EP) and group practices cannot earn an incentive under both the eRx and the EHR incentive programs for the same year. Also, EPs will be subject to an e-prescribing payment adjustment if they do not meet the requirements under the eRx program, regardless of whether they participate in and earn an incentive under the EHR program.

Under the eRx incentive program, physicians who use a qualified e-prescribing system are eligible for an additional 1% in Medicare Part B payments in 2011 and 2012, and a 0.5% increase in 2013. But providers who fail to complete at least 10 paperless electronic prescriptions using such a system between January 1 and June 30, 2011 will receive a 1% cut in Medicare reimbursements in 2012, a 1.5% cut in 2013, and a 2% cut in 2014.

The American Medical Association welcomed the flexibility of the proposed rule and the elimination of unreasonable penalties. “Physicians who are working to adopt e-prescribing and other health IT should not be unfairly penalized for practice patterns that do not fit neatly within the current, limited exemption process,” said Dr. Cecil Wilson, AMA president, in a statement.

Among the 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.

The EHR program also requires the EHR technology to be tested and certified by a certification body authorized by the National Coordinator for Health Information Technology, and even the eRx system to be certified by bodies like Surescripts. Surescripts has the nation’s largest e-prescription network. The eRx incentive program, however, does not require adoption of a certified e-prescription system.

(Source: CMS & Government Health IT)

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