Doctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012.
The penalty will increase to 1.5% in 2013 for those who don’t e-prescribe for 25 Medicare patients during 2011.
Not yet e-prescribing?
Maybe your EMR will be implemented soon, but maybe not soon enough!
If you’ve already contracted for an EMR, ask your vendor if you can leapfrog the typical implementation process so that you can submit the minimum 10 e-prescriptions before June 30.
That means that you’ll have the EMR in place, but you should use it only to e-prescribe. If you try to get into other functions and modules you’ll risk a poor implementation, and that isn’t fair to your vendor, especially if they help you out by getting you on the e-prescribing function quickly.
In addition to actually writing the prescription in the EMR and submitting it electronically to the pharmacy, you’ll need to bill G-code G8553 on the same claim form with the Evaluation and Management (E&M) code for the patient.
No EMR yet?
You may not be ready to take on the full ARRA HITECH incentive plan and bring an EMR into your practice, but that doesn’t mean that you have to accept a reduction in your Medicare Part B physician fee schedule.
If you haven’t yet made an EMR purchase, you can still e-prescribe using a dedicated application for e-prescribing while you maintain your paper charts.
The applications range from free to a few hundred dollars per provider per year.
The key is to get started fast!
You have only a few weeks to:
- Pick your product: two leading applications are available at www.nationalerx.com and www.rxnt.com
- Acquire and install hardware: you’ll need at least one PC for yourself and probably another for your nurse
- Learn how to use the software: include your nursing staff and your billing staff in training
- Determine how you’ll integrate prescribing electronically into your day-to-day visit work flow: the patient medications list will be maintained in the software application while the rest of the clinical documents are maintained in the paper chart
- Modify your superbill/encounter slip to accommodate the G-code G8553 to insure that you capture and submit the G-code with every visit that includes an electronic prescription.
The e-prescribing incentive program penalties were included in the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008.
Penalties increase each calendar year from 2012 through 2014. Regardless of whether or not a physician receives incentives under ARRA, he/she must continue to comply with the MIPPA e-prescribing requirements (i.e., G-coding) to avoid future MIPPA penalties.
Step up now to avoid the penalty in 2012.
Rosemarie Nelson is a principal with the MGMA Health Care Consulting Group.