American College of Cardiology

CMS e-Prescribing Incentive Program

Congress passed H.R. 6331, “Medicare Improvements for Patients and Providers Act of 2008 (MIPPA),” on July 15, 2008. It contains the following provisions:

• Physicians for whom services identified represent at least 10% of their Medicare charges are eligible to receive a 2% bonus payment in 2009 and 2010 if they use a qualified e-Prescribing system. The bonus is reduced to 1% in 2011 and 2012, and 0.5% in 2013.
  
• If physicians for whom these codes represent 10% of their charges do not use e-Prescribing, they will face penalties of -1% in 2012, -1.5% in 2013, and -2% in 2014 and beyond.
  
• Incentive payments and penalties are based on allowed charges for all covered Medicare services.
  
• Exceptions will be made for significant hardships (e.g., rural areas without sufficient Internet access).
  
• The GAO is required to issue a report by September 1, 2012 that includes information on the use and benefits of e-Prescribing.
  
• Payment bonuses are made after the adoption of a qualified e-Prescribing system, not as an up-front payment to facilitate initial investments.

The ACC has prepared a Claims-Based Participation in Medicare’s Electronic Prescribing Incentive Program guide to help our members understand exactly how the incentive program will work and how to participate.

Additional information directly from CMS:

• e-Prescribing Incentive Program Homepage
• CMS e-Prescribing Incentive Factsheet
• CMS has also published the exact e-Prescribing Measure Specifications for reporting the measure that will be used to determine if an eligible professional is a successful e-prescriber and can qualify for a 2% incentive payment for 2009.
• 2009 Electronic Prescribing (E-Prescribing) Incentive Program Made Simple.
  In addition to the e-prescribing specifications document, CMS has created a step-by-step guide, to help eligible professionals determine their eligibility to participate in the e-prescribing incentive program, and walk through the e-prescribing process.