Health IT

Catch-22 in CMS eRX and EHR Incentive Programs

Damned if you do, damned if you don’t. That’s the predicament many providers find themselves in with the two current CMS eRx initiatives. The 2008 MIPPA (Medicare Improvements for Patients and Providers Act ) legislation authorized CMS to provide incentives of up to 2 % of generated Medicare Part B payments for providers that met […]

Damned if you do, damned if you don’t. That’s the predicament many providers find themselves in with the two current CMS eRx initiatives.

The 2008 MIPPA (Medicare Improvements for Patients and Providers Act ) legislation authorized CMS to provide incentives of up to 2 % of generated Medicare Part B payments for providers that met e-prescribing requirments. The penalty side of the equation is 1 % on 2012 Medicare payments for providers who do not meet the minimum threshold of sending at least 10 ePrescriptions between January 1-June 30th 2011. As it stands now a provider could meet Stage 1 Meaningful Use for 2011 (which includes eRx functionality) and receive incentives but fall short of the MIPPA requirements and face financial penalties.

The June 30, 2011 deadline to meet eRx requirements and forestall penalties is fast approaching. There is now an aggressive plan underway to harmonize the two incentive/penalty programs that relate to eRx. On June 1, 2011 CMS issued a proposed rule to align the MIPAA eRx program with the CMS EHR Incentive program to give providers who meet 2011 meaningful use the ability to claim an exemption to the eRx penalties.

Hopefully, this can be resolved quickly so the cloud of uncertainty and potential penalties currently hanging over the majority of physicians who received Medicare reimbursement can be removed.

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