E-Prescribing: Medicare offers 2 percent e-prescribing bonus in 2009

November 26, 2008
Morgan Lewis Jr.
Morgan Lewis Jr.

The Centers for Medicare & Medicaid Services announced in late October that it will award an incentive payment of 2 percent of a physician's total Medicare allowed charges to doctors who use e-prescribing systems next year.

The Centers for Medicare & Medicaid Services announced in late October that it will award an incentive payment of 2 percent of a physician’s total Medicare allowed charges to doctors who use e-prescribing systems next year.

That bonus is in addition to the scheduled 1.1 percent Medicare rate increase and the optional 2 percent bonus for physicians who participate in the Physicians Quality Reporting Initiative, which awards practices for reporting at least three of 118 possible performance measures to CMS.

To earn the e-prescribing bonus, physicians must use a “qualified” e-prescribing system. While CMS does not provide a list of qualified e-prescribing programs, a directory can be found at the SureScripts website. Standalone systems can range from free to more than $2,500 a year, per prescriber.

In order to receive the bonus, qualified systems must be able to, according to CMS:

Communicate with the patient’s pharmacy;

Help the physician identify appropriate drugs and provide information on lower cost alternatives for the patient;

Provide information on formulary and tiered formulary medications; and

Generate alerts about possible adverse events, such as improper dosing, drug-to-drug interactions, or allergy concerns.

Physicians who agree to start e-prescribing for their Medicare patients must report the one of three “G-codes” when submitting claims that indicates:

They did not prescribe any medications during the visit;

They used e-prescribing for any medications prescribed during the visit; or

They did not use e-prescribing for a prescription because the law prohibits electronic prescribing for the specific type of drug, such as a controlled substance.

Jeffrey Hyman, MD, an internist in who runs a three-physician urgent clinic in Brooklyn, New York, which is part of the 60-physician University Physicians Group, is pursuing the PQRI bonus this year, and plans to add e-prescribing next year in his reporting. Hyman, whose e-prescribing software is part of his practice’s electronic health record from iMedica, feels adding a stand alone e-prescribing system with paper charts would be too time-consuming to justify the bonus.

“I strongly recommend getting the 2 percent from the government – that’s a no-brainer,” says Hyman, who has had an EHR system since 2002.  He adds what you have to do now in the paper world is write the prescription in the paper chart, then pick up a Pocket PC and type in the information, then have someone download the patient information, formulary, insurance carrier, and then type the prescription in again and then send it. It’s redundant.