MIPPA and e-Prescribe Updates

MIPPA, the Medicare Improvements for Patients and Providers Act of 2008, created a program that promoted e-prescribing (e-RX) technology. Physicians who adopted this new technology were eligible for a bonus payment on their Medicare fee schedule. 2011 is the final year for the bonus. Equally important, in 2012 physicians who do not e-prescribe will see payment reductions unless they either qualify for exemption status or meet the following 2011 reporting requirement.

2011 Reporting Requirement

Qualifying physicians should have reported the proper G Code (G8553) on at least 10 Medicare Part B claims between January 01 – June 30, 2011 to avoid the 2012 penalty. CMS issued a proposed rule by adding more exemption categories. To avoid the 2012 e-prescribing penalty, physicians will now have an opportunity to attest that they met an exemption through the online web portal.

What if I did not meet the 2011 reporting requirements?

Physicians can still avoid the 2012 penalty if they meet one of the following exemptions by October 1, 2011.

  1. Your practice is located in a rural area without high speed internet access.
  2. Your practice is in an area that has insufficient access to pharmacies for e-RX.
  3. You are registered in the Medicare or Medicaid (EHR) Incentive Program and have certified (EHR) Technology.
  4. You are unable to e-prescribe due to state, local or federal laws with regards to controlled substances.
  5. You prescribe too infrequently, less than the original 10 e-prescribe events required in the original January – June requirement.
  6. You experience insufficient opportunities to e-prescribe due to program limitations. For example, if you cannot e-prescribe on the date of the appointment as mandated.

Watch for information to evolve as the 2011 e-prescribe calendar draws to a close. Remember, you still have time to earn the 2011 1% Bonus for e-prescribing which will offset next year’s penalty.

Specialists at KSL can assist you with your EHR needs as well as help you prepare for 2012. Call (314) 450-8749 or email C. Michael Linder: cmlinder@kslinc.net