Medicare Payment Reduction on Tap for Physicians Who Don’t ePrescribe

Providers who have yet to participate in Medicare’s Electronic Prescribing (eRx) Incentive Program better get moving.

The program (authorized under the Medicare Improvements for Patients and Providers Act of 2008) provides for payments to eligible professionals, including physicians and group practices, equal to one percent of their total estimated Medicare Part B Physician Fee Schedule-allowed charges. However, it also called for a payment adjustment for covered providers who are not yet successful ePrescribers.



It’s not just the incentives and payment reductions that should propel providers into action (see chart). ePrescribing provides a host of benefits, such as driving greater efficiency by reducing paperwork and increasing medication dispensing accuracy. ePrescribing also provides additional patient safety measures missing from manual processes. The Journal of the American Medical Informatics Association reported in a 2007 article that more than one million serious drug errors occur in U.S. hospitals annually. Many ePrescribing technologies include medication reconciliation modules that allow providers to see prescription histories and reconcile medications at the point of care. Enabled ePrescribing systems can capture up to 95 percent of patient medication information, far more than what is revealed during patient interviews.

As a side note, CMS does realize that while a majority of physicians will easily comply with the incentive program, some will find it more difficult to ePrescribe. As a result, CMS will exempt individual eligible professionals and group practices participating in the ePrescribing program from the 2014 payment adjustments if requirements for becoming a successful electronic prescriber would result in a significant hardship. Providers will qualify for the exemption if they:

• are unable to submit electronic prescriptions due to local, state or federal law, or regulation;
• will prescribe fewer than 100 total prescriptions during the January-to-June reporting period;
• practice in a rural area without sufficient high-speed Internet access; or
• practice in an area without sufficient available pharmacies for electronic prescribing.

To request the hardship, individual eligible professionals and group practices must submit their significant exemption requests through the CMS Quality Reporting Communication Support webpage (https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234). CMS will review the requests on a case-by-case basis.

Fortunately, eligible providers considering their next steps towards becoming ePrescribing compliant have access to many enabling tools such as Emdeon Clinical Exchange EHR Lite, a component of Emdeon’s Office Suite. As a certified EHR Lite, this solution combines routine administrative health information exchange with consolidated ePrescribing as well as electronic lab ordering and results distribution.

These tools are specifically designed not only to help providers qualify for Meaningful Use and the eRx incentive, but to drive clinician efficiency and improve patient safety—two of the most important and compelling objectives healthcare has been challenged to address.

To learn more about tools for achieving eRx compliance, please review information about Emdeon Clinical Exchange EHR Lite on the Emdeon website.

¹ “Evaluation of Outpatient Computerized Physician Medication Order Entry Systems: A Systematic Review,” Journal of the Medical Informatics Association (JAMIA), July 2007.






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