Requirements for participation

To participate in the e-prescribing incentive program, physicians must have a qualified e-prescribing system with certain required capabilities. Qualified systems must be able to:

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

To earn the incentive payment, physicians must successfully report one of three codes for the e-prescribing measure when submitting claims for specified types of medical visits, indicating:

• They did not prescribe any medications during the visit;
• They used e-prescribing for any medications prescribed during the visit;
• 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.

As required by the Medicare Improvements for Patients and Providers Act of 2008, which became law on July 15, payment rates for physician fee schedule services will be increased by 1.1 percent in 2009, rather than being reduced by 5.4 percent as would have happened if CMS had applied the physician fee schedule conversion factor projected in the proposed rule.  

Total Medicare spending under the 2009 Physician Fee Schedule is projected at $61.9 billion, up 4 percent from the $59.5 billion projected for 2008.

Will Medicare incentives make in difference in whether you adopt e-prescribing? Send your comments to Bernie Monegain at bernie.monegain@medtechpublishing.com.