Managing Your Dermatology Practice

Managing Your Dermatology Practice: E-Prescribing Update

April 18, 2011

About this time last year, I wrote about electronic prescribing and the incentives that had been put in place to encourage adoption. Apparently, most of you were unimpressed; a year later e-prescribing use has increased only marginally.

The Centers for Medicare and Medicaid Services thought it could turn the tide in 2009 by adding a financial incentive: a 2% bonus on Medicare Part B payments. That didn't do the trick either; accessibility and cost issues remained, and the various "G" codes that had to be added to Medicare claims to document e-prescribing were confusing and annoying.

In 2010, CMS made it much easier to collect the incentive with minimum e-prescribing effort: If you could show that you were using a qualified e-prescribing program on only 25 Medicare claims over the course of the entire year, you got a 2% bonus on every Medicare Part B claim you filed over the entire year. They also replaced myriad confusing "G" codes with a single one, G8553.

If none of these incentives have swayed you, 2011 might be the year you are finally persuaded: CMS has not sweetened the deal.

In fact, the bonus is reduced to 1% this year. But 2011 is the last year you can avoid going electronic without generating a penalty.

In 2012, physicians filing at least the minimum 25 Medicare claims will receive a 1% bonus, but those not doing so will incur a 1% penalty.

In 2013, the incentive drops to 0.5%, and the penalty increases to 1.5%. In 2014, and beyond, there will be no incentive, but the penalty will rise to 2% and remain there.

To be clear (and I have been asked about this more than once), faxing a prescription to a pharmacy is not e-prescribing, which, by definition, is computer-to-computer (paperless) communication of prescriptions.

Many electronic medical record users are under the erroneous impression that they are e-prescribing via their EMR, when the EMR is simply generating faxes that arrive, on paper, in the pharmacy's fax machine. That is not considered e-prescribing by CMS, and it does not qualify for the financial incentive program.

A coalition of insurance and technology companies called the National ePrescribing Patient Safety Initiative (NEPSI) has provided $100 million in funding to offer free e-prescribing technology that qualifies for the program to physicians nationwide.
NEPSI members include Allscripts, Surescripts, and NaviMedix, as well as Google, Dell, Cisco Systems, Fujitsu, Microsoft, Sprint Nextel, Aetna, Horizon Blue Cross Blue Shield, WellPoint, and Wolters Kluwer Health. (I have no financial interest in any company or product mentioned in this column.)