CMS E-Prescribing Incentives

As of January 1, 2009, clinicians are eligible for a bonus payment under Medicare if they are e-prescribing and report such on at least fifty percent of Medicare patients through submitted claims.

Clinicians can receive bonuses of two percent of Medicare allowed charges in 2009 and 2010; one percent in 2011 and 2012; and a half percent in 2013.  Beginning in 2012, there will be a penalty for those not e-prescribing, which increases to two percent of Medicare allowed charges in 2014.

To be eligible for the incentive, the prescriber must use a qualified system.  This can be either a stand-alone e-prescribing application or an integrated part of an electronic health record (EHR) system.  In either case, the system must be able to do all of the following:

• Generate a complete active medication list incorporating electronic data received from applicable pharmacies and benefit managers (PBMs), if available
  
• Select medications, print prescriptions, electronically transmit prescriptions, and conduct safety alerts (such as drug-drug interactions)
  
• Provide information related to lower cost, therapeutically appropriate alternatives (The availability of tiered formulary information would meet this requirement for 2009.)
• Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available