E- Prescribing  – Incentive qualified

Medicare Incentive for “Qualified eRx”:

According to the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, any provider who meets an annual threshold of e–prescribing/ patients volume will get incentive payments from Medicare which will start at 2 percent for 2009 and 2010, and then drop to 1 percent in 2011 and 2012 and subsequently fall to 0.5 percent in 2013.

However, those providers who are not adopting E-prescribing, their Medicare reimbursements will decrease by 1 percent in 2012, 1.5 percent in 2013 and 2 percent in 2014 and later.

Those providers who are adopting e-prescribing early will be eligible for the following Medicare reimbursements:

Providers are adopting e-prescribing by year         Receive Medicare reimbursements ( %)
                    2009                                                                     2
                    2010                                                                     2
                    2011                                                                     1
                    2012                                                                     1
                    2013                                                                     0.5     

Those providers who are not adopting e-prescribing by 2012, their Medicare reimbursements will decrease as follows:

Providers are not adopting e-prescribing by year       Medicare reimbursements decrease by (%)

                                     2012                                                                          1.0
                                     2013                                                                          1.5
                                     2014                                                                          2.00
2015 and subsequent year.

A “Qualified eRx” must be competent enough to performing all of the following functions. 

  • Generate a complete active medication list
  • Select medications, print prescriptions, electronically transmit prescriptions, and conduct all time alerts(safety checks include: automated prompts that offer information on the drug being prescribed, potential inappropriate dose or route of administration, drug-drug interactions, allergy concerns, or warnings or cautions)
  • Provide information on lower-cost, therapeutically appropriate alternatives (if any)
  • Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan (if available)