Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

April 14, 2011

I thought as long as you used eRx with Surescripts it doesn't matter if the pharmacy is so enabled. SS will just fax it for you, but you get the eRx credit.

I imagine we will be able to meet the June cutoff for 10 claims, but is anyone frustrated that there isn't a code (is there?) for when the patient chooses to use a pharmacy that doesn't have eRx capability?

One of our local pharmacies doesn't have eRx yet.More and more Medicare are using mail-in meds - some of these mail-in pharmacies don't have eRx yet.

And sometimes, we get a Telecon for a refill and we use eRx to refill a medicine for the patient, but I haven't figured out if we can send a claim into Medicare with only a G8553 code and no other visit code.

How are others handling this?

Would an electronically transmitted prescription that is converted to a fax by Surescripts (because the requested pharmacy is not electronically enabled) count towards the 40% e-prescribing threshold under the Meaningful Use program?

CMS issued an FAQ on September 22, 2010, Answer ID 10137. We recommend that prescriber vendors review the referenced FAQ and contact CMS for further guidance if needed.-- Graham Chiuhttp://www.compkarori.co.nz:8090/

Synapse - the use from anywhere EMR.

April 14, 2011

,

I was just re-reading the interface with AC for E-Rx'ing and here is part of the service. E-Rx service ala SureScripts should be able to accept your E-Rx as sent to their server (again they are sort of a middleman getting a bit from everybody involved, great deal for them.... Was just share a good vent bitch with a Psychiatrist about why should we have to pay for a service that is really more in the interest of all the other players in this system as opposed to us.... Hand them the Rx at time of service, fax it, mail it whatever) where it is then their job as the middleman here to get to the right guy on the other side of the transmission to then fill the Rx for us and the patient... So as stated right on the AC website is something just like this: and for those pharmacies that do not yet participate with E-Rx'ing we will fax the script to those places....

So as far as I'm concerned once we do our part enter it in the EMR and hit send or transmit and perhaps get a confirmation from SureScripts that it has been recieved, at that point it is no longer our problem, We "Transmitted" the script properly to the first part of the system and after that it is out of our hands... Chain of custody like, we carried it as far as we were allowed or able, and now we properly passed the batton to the next guy in-line, the next one in the food chain to then properly do his part from there.... This should certainly count.... It would be like banging us for not doing something that is out of our control post transfer of care, referal like at someone else's office.... Like I sent them the referal and gave them the Auth Number I properly got from the carrier too... What they did with it on their side after I did what was within my control I have no idea....

http://amazingcharts.com/services/interfaces/eprescribing/

ePrescribing, Powered by NewCrop, a SureScripts Certified Solution

Amazing Charts provides a state-of-the-art integrated ePrescribing solution. This feature is included at no additional charge for users who subscribe to our annual maintenance service (in Amazing Charts V5 and above).

Amazing Charts ePrescribing includes:

Comprehensive medication information from Lexi-Comp, including Drug/Drug and Drug/Allergy interactions

Two-way electronic connectivity to pharmacies via the Surescripts Electronic Prescribing Networkâ„¢

For those pharmacies that are not a part of the Surescripts Electronic Prescribing Networkâ„¢, we provide nationwide faxing

Comprehensive managed care formulary from MediMedia and RxHub

Medicare Part D Formularies

Practice-wide refill management from one screen

Patient medication hand-outs (in 18 languages)

Because of the need to control and verify users of e-prescribing, only registered Amazing Charts' users can activate e-prescribing features. Once registered, you can activate this feature under the Administration section of Amazing Charts. If you have any problems activating the service, please contact us at here.

*Please be sure to review the Amazing Charts license agreement on this, and our other services. Amazing Charts offers a number of optional services that will maximize your practice efficiency while lowering your expenses. Only licensed users who are verified may use our prescribing features. Users/Practices still in their trial period are not able to use these prescribing features.

To: ; Practice Management Issues ; "Bruce Bowen, MD" ; Dr. Borchers ; Glenn Kotz ; Ann Mass ; Dr. Zimet ; Locke Sent: Wed, April 13, 2011 10:31:42 PMSubject: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report

in 2011 to avoid penalty in 2012

I imagine we will be able to meet the June cutoff for 10 claims, but is anyone frustrated that there isn't a code (is there?) for when the patient chooses to use a pharmacy that doesn't have eRx capability?

One of our local pharmacies doesn't have eRx yet.More and more Medicare are using mail-in meds - some of these mail-in pharmacies don't have eRx yet.

And sometimes, we get a Telecon for a refill and we use eRx to refill a medicine for the patient, but I haven't figured out if we can send a claim into Medicare with only a G8553 code and no other visit code.

How are others handling this?

Locke, MD

I wasn't clear on my original post -- I was curious about the total # of patients that have to be reported during the year - not the CPT code (G8553)

I understand we can only try for one of the incentive plans -- but wasn't there some mention that if we didn't prove we are using eRx, we could get docked on Medicare pay for next year?

Does anyone understand this?

I got the impression that even if you weren't going for incentive pay for the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in 2012..

================

Further googling suggests...

http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

Since 2009, the Centers for Medicare and Medicaid Services has offered an incentive for eligible professionals (EP) to implement and use electronic prescribing (eRx) in order to improve the quality, efficiency and safety of healthcare delivered to beneficiaries. This initiative will continue in 2011 with successful e-prescribers earning a bonus of 1% of their total allowed charges for professional services covered by the Medicare Part B Physician Fee Schedule. However, for the first time, the 2011 eRx program now includes a payment-adjustment or penalty component. EPs who do not implement and use an eRx system in 2011 will be penalized in 2012 and 2013 through a cut to their Medicare payments! You have only until June 30, 2011 to avoid a 1 % cut in your 2012 allowable Physician Fee Schedule billings and until December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings! A full description of the 2011 eRx incentive program and

related penalties is available at http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf.

Even if you are planning to participate in the e-prescribing incentive program and/or the EHR incentive program, you can still be liable for the cut. The only way to avoid the 2012 cut is to file Medicare claims that document 10 qualifying e-prescription events prior to June 30, 2011 â€“ only a few months from now. While you may plan to meet the incentive requirements by the end of 2011 via claims or any other method, be certain that you successfully file your 10 claims before the end of June.

To avoid the 2013 penalty of 1 Â½ % of total allowed charged under Medicare Part B, you will need to file Medicare claims that document 25 qualifying e-prescription events prior to December 31, 2011. Thus, you may want to file the full 25 claims as soon as possible to avoid all eRx related penalties for both 2012 and 2013.

==============================

Good article from ACP here..

http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

==================================

Excellent review here...

Understanding the basics of Medicareâ€™s Electronic Prescribing Incentive Program

http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

====================================

http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

=========================

http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

============================

http://www.healthdatamanagement.com/news/cms-e-prescribing-pqri-conference-call-42079-1.html

CMS to Explain PQRI, E-Prescribing Programs

HDM Breaking News, February 28, 2011

The Centers for Medicare and Medicaid Services will conduct a conference call and simultaneous Web seminar on March 8 to discuss the 2011 Physician Quality Reporting System and Electronic Prescribing Incentive Program.

Participants not participating in the Web seminar are encouraged to download the presentation for the conference call in advance at cms.gov/PQRI/04_CMSSponsoredCalls.asp.

Registration is available at eventsvc.com/palmettogba/030811. Registration will close on March 7 or sooner if space is filled. Additional information on the reporting and e-prescribing incentive programs is available at cms.gov/pqri and cms.gov/erxincentive.

=========================================

http://www.cms.gov/erxincentive/

Electronic Prescribing (eRx) Incentive Program

Click on the "Spotlight" link to the left to view

"What's New" (recently posted items) for the eRx Incentive Program

Background. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for eligible professionals (EPs) who are successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI). Eligible professionals do not need to participate in PQRI to participate in the Electronic Prescribing (eRx) Incentive Program.

For each program year, CMS implements the eRx Incentive Program through an annual rulemaking process published in the Federal Register. Information regarding the relevant statutes and regulations can be found by clicking on the "Statutes/Regulations" section page to the left.

A list of professionals eligible to participate in the eRx Incentive Program is available by clicking on the "Eligible Professionals" link at left.

No Sign Up or Pre-Registration

There is no sign-up or pre-registration to for individual EPs to participate in the eRx Incentive Program. However, there are certain limitations for who can qualify for an eRx incentive payment. First, an EP must have and use a qualified eRx system and report on his or her adoption and use of the eRx system. Second, the EP must meet the criteria for successful electronic prescriber specified by CMS for a particular reporting period. Finally, at least 10% of a successful electronic prescriber's Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure.

Note: The eRx Incentive Program requirements and measure specifications for the current program year may be different from the eRx Incentive Program requirements and measure specifications for a prior year. EPs are responsible for ensuring that they are using the eRx incentive documents for the correct program year.

2010 eRx Incentive Program

To participate in the 2010 eRx Incentive program, individual EPs may choose to report on their adoption and use of a qualified eRx system by submitting information on one eRx measure: (1) to CMS on their Medicare part B claims, (2) to a qualified registry, or (3) to CMS via a qualified electronic health record (EHR) product. Additional information on the registry-based or EHR-based reporting mechanism for the eRx Incentive Program is available by clicking on the "Alternative Reporting Mechanisms" link at left.

To be considered a successful electronic prescriber for the 2010 eRx Incentive Program and potentially qualify to earn a 2.0% incentive payment for the 2010 eRx Incentive Program, an individual EP must report the eRx measure for at least 25 unique electronic prescribing events in which the measure is reportable by the EP during 2010.

Beginning with the 2010 eRx Incentive Program, a group practice may also potentially qualify to earn an eRx incentive payment equal to 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the 2010 eRx reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS. Click on the "Group Practice Reporting Option" link at left to learn more about this reporting option and to obtain instructions on how a group practice can sign up to participate in this reporting option.

2009 eRx Incentive Program

To participate in the 2009 eRx Incentive Program, individual EPs must report on their adoption and use of a qualified eRx system by submitting claims information on one eRx measure on their Medicare Part B claims. To be considered a successful electronic prescriber for 2009 and potentially qualify to earn a 2.0% incentive payment for the 2009 eRx Incentive Program, an individual EP must report the eRx measure in at least 50% of the cases in which the measure is reportable by the EP during 2009.

Information on the eRx measure can be found by clicking on the "eRx Measure" section page to the left.

Additional resources to help EPs become successful electronic prescribers can be found by clicking on the "Educational Resources" section page to the left.

To find out who to contact with questions regarding the eRx Incentive Program, click on the "Help Desk Support" link at left.

============================

http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf on the CMS website for more information; or download the Medicareâ€™s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.

If an eligible professional or selected group practice wishes to request an exemption to the eRx Incentive Program and the payment adjustment, there are two "hardship codes" that can be reported via claims should one of the following situations apply:

â€¢ G8642 - The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

â€¢ G8643 - The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act

Additionally, there will be a G code which can be used by eligible professionals to indicate that they do not have prescribing privileges. Reporting this G code will prevent the eligible professional from being subjected to a payment adjustment in 2012.

========================================

====================================================

PQRI info is...

http://www.cms.gov/pqri/

Locke, MD

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April 14, 2011

, Is Â eRx an added cost with your EMR?Â I assumed it was free or at least a hidden cost since they likely sell information about us to pharmaceutical companies and who knows for what other purposes.Â Â Iâ€™m imagining itâ€™s a great way for attorneys to scoop up information for law suits.Â Does your eRx agreement offer an opt out option about sharing/selling your prescribing information?Â Â Got a news release from Practice Fusion yesterday announcing free eRx.Â Â No mention of formularies but claimed 65,000 pharmacies.Â Seems like several others offered free eRx in the past (Allscripts, NuNova).Â From a practical standpoint the only eRx that makes sense is the one our EMR vendor offers. Also curious what the story is on size of formulary files that have to be stored and backed up locally? Are any EMR vendors pricing eRx as an additional charge with their â€œmeaningful useâ€ upgrades?Â Seems like it has to be part of the basic package to be â€œmeaningfulâ€. Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR/Billing since 2009 From: [mailto: ] On Behalf Of BleiweissSent: Wednesday, April 13, 2011 10:46 PMTo: ; Practice Management Issues; Bruce Bowen, MD; Dr. Borchers; Dr. Niebur; Glenn Kotz; Kim Scheuer; Ann Mass; Check; Dr. Zimet; Locke; LockeSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 , I was just re-reading the interface with AC for E-Rx'ing and here is part of the service. E-Rx service ala SureScripts should be able to accept your E-Rx as sent to their server (again they are sort of a middleman getting a bit from everybody involved, great deal for them.... Was just share a good vent bitch with a Psychiatrist about why should we have to pay for a service that is really more in the interest of all the other players in this system as opposed to us.... Hand them the Rx at time of service, fax it, mail it whatever) where it is then their job as the middleman here to get to the right guy on the other side of the transmission to then fill the Rx for us and the patient... So as stated right on the AC website is something just like this: and for those pharmacies that do not yet participate with E-Rx'ing we will fax the script to those places.... So as far as I'm concerned once we do our part enter it in the EMR and hit send or transmit and perhaps get a confirmation from SureScripts that it has been recieved, at that point it is no longer our problem, We " Transmitted " the script properly to the first part of the system and after that it is out of our hands... Chain of custody like, we carried it as far as we were allowed or able, and now we properly passed the batton to the next guy in-line, the next one in the food chain to then properly do his part from there.... This should certainly count.... It would be like banging us for not doing something that is out of our control post transfer of care, referal like at someone else's office.... Like I sent them the referal and gave them the Auth Number I properly got from the carrier too... What they did with it on their side after I did what was within my control I have no idea.... http://amazingcharts.com/services/interfaces/eprescribing/ ePrescribing, Powered by NewCrop, a SureScripts Certified SolutionAmazing Charts provides a state-of-the-art integrated ePrescribing solution. This feature is included at no additional charge for users who subscribe to our annual maintenance service (in Amazing Charts V5 and above). Amazing Charts ePrescribing includes:Comprehensive medication information from Lexi-Comp, including Drug/Drug and Drug/Allergy interactionsTwo-way electronic connectivity to pharmacies via the Surescripts Electronic Prescribing Networkâ„¢ For those pharmacies that are not a part of the Surescripts Electronic Prescribing Networkâ„¢, we provide nationwide faxingComprehensive managed care formulary from MediMedia and RxHubMedicare Part D FormulariesPractice-wide refill management from one screenPatient medication hand-outs (in 18 languages)Because of the need to control and verify users of e-prescribing, only registered Amazing Charts' users can activate e-prescribing features. Once registered, you can activate this feature under the Administration section of Amazing Charts. If you have any problems activating the service, please contact us at here. *Please be sure to review the Amazing Charts license agreement on this, and our other services. Amazing Charts offers a number of optional services that will maximize your practice efficiency while lowering your expenses. Only licensed users who are verified may use our prescribing features. Users/Practices still in their trial period are not able to use these prescribing features. To: ; Practice Management Issues ; " Bruce Bowen, MD " ; Dr. Borchers ; Glenn Kotz ; Ann Mass ; Dr. Zimet ; Locke Sent: Wed, April 13, 2011 10:31:42 PMSubject: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 I imagine we will be able to meet the June cutoff for 10 claims, but is anyone frustrated that there isn't a code (is there?) for when the patient chooses to use a pharmacy that doesn't have eRx capability? One of our local pharmacies doesn't have eRx yet.More and more Medicare are using mail-in meds - some of these mail-in pharmacies don't have eRx yet.And sometimes, we get a Telecon for a refill and we use eRx to refill a medicine for the patient, but I haven't figured out if we can send a claim into Medicare with only a G8553 code and no other visit code. How are others handling this? Locke, MDI wasn't clear on my original post -- I was curious about the total # of patients that have to be reported during the year - not the CPT code (G8553) I understand we can only try for one of the incentive plans -- but wasn't there some mention that if we didn't prove we are using eRx, we could get docked on Medicare pay for next year? Does anyone understand this? I got the impression that even if you weren't going for incentive pay for the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in 2012..================Further googling suggests... http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdfSince 2009, the Centers for Medicare and Medicaid Services has offered an incentive for eligible professionals (EP) to implement and use electronic prescribing (eRx) in order to improve the quality, efficiency and safety of healthcare delivered to beneficiaries. This initiative will continue in 2011 with successful e-prescribers earning a bonus of 1% of their total allowed charges for professional services covered by the Medicare Part B Physician Fee Schedule. However, for the first time, the 2011 eRx program now includes a payment-adjustment or penalty component. EPs who do not implement and use an eRx system in 2011 will be penalized in 2012 and 2013 through a cut to their Medicare payments! You have only until June 30, 2011 to avoid a 1 % cut in your 2012 allowable Physician Fee Schedule billings and until December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings! A full description of the 2011 eRx incentive program and related penalties is available at http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf. Even if you are planning to participate in the e-prescribing incentive program and/or the EHR incentive program, you can still be liable for the cut. The only way to avoid the 2012 cut is to file Medicare claims that document 10 qualifying e-prescription events prior to June 30, 2011 â€“ only a few months from now. While you may plan to meet the incentive requirements by the end of 2011 via claims or any other method, be certain that you successfully file your 10 claims before the end of June. To avoid the 2013 penalty of 1 Â½ % of total allowed charged under Medicare Part B, you will need to file Medicare claims that document 25 qualifying e-prescription events prior to December 31, 2011. Thus, you may want to file the full 25 claims as soon as possible to avoid all eRx related penalties for both 2012 and 2013. ==============================Good article from ACP here..http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf==================================Excellent review here...Understanding the basics of Medicareâ€™s Electronic Prescribing Incentive Program http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf====================================http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/=========================http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf============================ http://www.healthdatamanagement.com/news/cms-e-prescribing-pqri-conference-call-42079-1.html CMS to Explain PQRI, E-Prescribing ProgramsHDM Breaking News, February 28, 2011 The Centers for Medicare and Medicaid Services will conduct a conference call and simultaneous Web seminar on March 8 to discuss the 2011 Physician Quality Reporting System and Electronic Prescribing Incentive Program.Participants not participating in the Web seminar are encouraged to download the presentation for the conference call in advance at cms.gov/PQRI/04_CMSSponsoredCalls.asp.Registration is available at eventsvc.com/palmettogba/030811. Registration will close on March 7 or sooner if space is filled. Additional information on the reporting and e-prescribing incentive programs is available at cms.gov/pqri and cms.gov/erxincentive.=========================================http://www.cms.gov/erxincentive/Electronic Prescribing (eRx) Incentive ProgramClick on the " Spotlight " link to the left to view " What's New " (recently posted items) for the eRx Incentive ProgramBackground. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for eligible professionals (EPs) who are successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI). Eligible professionals do not need to participate in PQRI to participate in the Electronic Prescribing (eRx) Incentive Program.For each program year, CMS implements the eRx Incentive Program through an annual rulemaking process published in the Federal Register. Information regarding the relevant statutes and regulations can be found by clicking on the " Statutes/Regulations " section page to the left.A list of professionals eligible to participate in the eRx Incentive Program is available by clicking on the " Eligible Professionals " link at left.No Sign Up or Pre-RegistrationThere is no sign-up or pre-registration to for individual EPs to participate in the eRx Incentive Program. However, there are certain limitations for who can qualify for an eRx incentive payment. First, an EP must have and use a qualified eRx system and report on his or her adoption and use of the eRx system. Second, the EP must meet the criteria for successful electronic prescriber specified by CMS for a particular reporting period. Finally, at least 10% of a successful electronic prescriber's Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure.Note: The eRx Incentive Program requirements and measure specifications for the current program year may be different from the eRx Incentive Program requirements and measure specifications for a prior year. EPs are responsible for ensuring that they are using the eRx incentive documents for the correct program year.2010 eRx Incentive ProgramTo participate in the 2010 eRx Incentive program, individual EPs may choose to report on their adoption and use of a qualified eRx system by submitting information on one eRx measure: (1) to CMS on their Medicare part B claims, (2) to a qualified registry, or (3) to CMS via a qualified electronic health record (EHR) product. Additional information on the registry-based or EHR-based reporting mechanism for the eRx Incentive Program is available by clicking on the " Alternative Reporting Mechanisms " link at left.To be considered a successful electronic prescriber for the 2010 eRx Incentive Program and potentially qualify to earn a 2.0% incentive payment for the 2010 eRx Incentive Program, an individual EP must report the eRx measure for at least 25 unique electronic prescribing events in which the measure is reportable by the EP during 2010.Beginning with the 2010 eRx Incentive Program, a group practice may also potentially qualify to earn an eRx incentive payment equal to 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the 2010 eRx reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS. Click on the " Group Practice Reporting Option " link at left to learn more about this reporting option and to obtain instructions on how a group practice can sign up to participate in this reporting option.2009 eRx Incentive ProgramTo participate in the 2009 eRx Incentive Program, individual EPs must report on their adoption and use of a qualified eRx system by submitting claims information on one eRx measure on their Medicare Part B claims. To be considered a successful electronic prescriber for 2009 and potentially qualify to earn a 2.0% incentive payment for the 2009 eRx Incentive Program, an individual EP must report the eRx measure in at least 50% of the cases in which the measure is reportable by the EP during 2009.Information on the eRx measure can be found by clicking on the " eRx Measure " section page to the left.Additional resources to help EPs become successful electronic prescribers can be found by clicking on the " Educational Resources " section page to the left.To find out who to contact with questions regarding the eRx Incentive Program, click on the " Help Desk Support " link at left. ============================http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf on the CMS website for more information; or download the Medicareâ€™s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources. If an eligible professional or selected group practice wishes to request an exemption to the eRx Incentive Program and the payment adjustment, there are two " hardship codes " that can be reported via claims should one of the following situations apply: â€¢ G8642 - The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act. â€¢ G8643 - The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act Additionally, there will be a G code which can be used by eligible professionals to indicate that they do not have prescribing privileges. Reporting this G code will prevent the eligible professional from being subjected to a payment adjustment in 2012.============================================================================================PQRI info is... http://www.cms.gov/pqri/ Locke, MD Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (1) Recent Activity: Â· New Members 2 Visit Your Group MARKETPLACEFind useful articles and helpful tips on living with Fibromyalgia. Visit the Fibromyalgia Zone today!Stay on top of your group activity without leaving the page you're on - Get the Yahoo! Toolbar now.Switch to: Text-Only, Daily Digest â€¢ Unsubscribe â€¢ Terms of Use.

April 14, 2011

,

I do not have answers to all your questions at the moment although they are certain valid concerns that I share.... That said doing such is not a huge thing on my radar screen for the moment, I was just knocking around the AC website simply because it is time for us to re-up with them for our annual support and I was confused about another issue relating to all of that for us older long term users... BUT I do know that AC has a section on their website about Corporate Responsibility and that includes that they will never sell our patients info and data because once out of our or their hands, one can never be 100% sure what becomes of it from there. So as they word it, they "Leave that money on the table" instead of making money on all of us and then we and they all run that unquantifiable risk.

Now whether or not SureScripts has the same kind of ethical privacy policy no less what are the privacy policies of all of the pharmacies around the country is a great question and one I do not expect a good and healthy response to. I've got the feeling that a company that connected is not going to have as ethical a policy as someone like Dr Jon and AC do. Like us IMP'ers most of the AC users are also a more independent and ethical minded set of folks. That is why they like us are in small or solo practices using a product like AC which is specifically targeted towards folks like us in the first place....

I would say contact SureScripts and AC to see if they can supply you would solid answers to your questions about the next couple of people in the food chain post AC.... And yes E-Rx'ing is a "free" value added service one just has to work with AC for a bit to properly activate because of appropriate concerns about making absolutely sure those who activate it are truly licensed users who have valid and in place DEA licenses. Now AC did finally institute a real and sizeable price increase as they moved forward with CCHIT and meaningful use like extras and programing so whether or not you would really call it free is up to the individual. But clearly their pricing structure and basically policies are still some of the best in the business and still fit most of us IMP'ers and other small, solo folks. I gather AC and other vendors could potentially get in trouble if they allowed such a instant kind of service to fall into the

wrong hands, no less the actual ethical and other legal and liability issues that would surround having non licensed professionals writing Rx's for goodness only knows what... But it is supposed to be a pretty easy one or two phone calls or emails kind of process because for the most part they know all of their users pretty well and they are NOT some huge bloated GE like company...

Gotta Fly here,

To: Sent: Thu, April 14, 2011 8:07:15 AMSubject: RE: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

,

Is eRx an added cost with your EMR? I assumed it was free or at least a hidden cost since they likely sell information about us to pharmaceutical companies and who knows for what other purposes. Iâ€™m imagining itâ€™s a great way for attorneys to scoop up information for law suits. Does your eRx agreement offer an opt out option about sharing/selling your prescribing information?

Got a news release from Practice Fusion yesterday announcing free eRx. No mention of formularies but claimed 65,000 pharmacies. Seems like several others offered free eRx in the past (Allscripts, NuNova). From a practical standpoint the only eRx that makes sense is the one our EMR vendor offers.

Also curious what the story is on size of formulary files that have to be stored and backed up locally?

Are any EMR vendors pricing eRx as an additional charge with their â€œmeaningful useâ€ upgrades? Seems like it has to be part of the basic package to be â€œmeaningfulâ€.

Neighbors, MD

Huntsville, Alabama

Solo using FlexMedical EMR/Billing since 2009

From: [mailto: ] On Behalf Of BleiweissSent: Wednesday, April 13, 2011 10:46 PMTo: ; Practice Management Issues; Bruce Bowen, MD; Dr. Borchers; Dr. Niebur; Glenn Kotz; Kim Scheuer; Ann Mass; Check; Dr. Zimet; Locke; LockeSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

,

I was just re-reading the interface with AC for E-Rx'ing and here is part of the service. E-Rx service ala SureScripts should be able to accept your E-Rx as sent to their server (again they are sort of a middleman getting a bit from everybody involved, great deal for them.... Was just share a good vent bitch with a Psychiatrist about why should we have to pay for a service that is really more in the interest of all the other players in this system as opposed to us.... Hand them the Rx at time of service, fax it, mail it whatever) where it is then their job as the middleman here to get to the right guy on the other side of the transmission to then fill the Rx for us and the patient... So as stated right on the AC website is something just like this: and for those pharmacies that do not yet participate with E-Rx'ing we will fax the script to those places....

So as far as I'm concerned once we do our part enter it in the EMR and hit send or transmit and perhaps get a confirmation from SureScripts that it has been recieved, at that point it is no longer our problem, We "Transmitted" the script properly to the first part of the system and after that it is out of our hands... Chain of custody like, we carried it as far as we were allowed or able, and now we properly passed the batton to the next guy in-line, the next one in the food chain to then properly do his part from there.... This should certainly count.... It would be like banging us for not doing something that is out of our control post transfer of care, referal like at someone else's office.... Like I sent them the referal and gave them the Auth Number I properly got from the carrier too... What they did with it on their side after I did what was within my control I have no idea....

http://amazingcharts.com/services/interfaces/eprescribing/

ePrescribing, Powered by NewCrop, a SureScripts Certified Solution

Amazing Charts provides a state-of-the-art integrated ePrescribing solution. This feature is included at no additional charge for users who subscribe to our annual maintenance service (in Amazing Charts V5 and above).

Amazing Charts ePrescribing includes:

Comprehensive medication information from Lexi-Comp, including Drug/Drug and Drug/Allergy interactions

Two-way electronic connectivity to pharmacies via the Surescripts Electronic Prescribing Networkâ„¢

For those pharmacies that are not a part of the Surescripts Electronic Prescribing Networkâ„¢, we provide nationwide faxing

Comprehensive managed care formulary from MediMedia and RxHub

Medicare Part D Formularies

Practice-wide refill management from one screen

Patient medication hand-outs (in 18 languages)

Because of the need to control and verify users of e-prescribing, only registered Amazing Charts' users can activate e-prescribing features. Once registered, you can activate this feature under the Administration section of Amazing Charts. If you have any problems activating the service, please contact us at here.

*Please be sure to review the Amazing Charts license agreement on this, and our other services. Amazing Charts offers a number of optional services that will maximize your practice efficiency while lowering your expenses. Only licensed users who are verified may use our prescribing features. Users/Practices still in their trial period are not able to use these prescribing features.

To: ; Practice Management Issues ; "Bruce Bowen, MD" ; Dr. Borchers ; Glenn Kotz ; Ann Mass ; Dr. Zimet ; Locke Sent: Wed, April 13, 2011 10:31:42 PMSubject: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

I imagine we will be able to meet the June cutoff for 10 claims, but is anyone frustrated that there isn't a code (is there?) for when the patient chooses to use a pharmacy that doesn't have eRx capability?

One of our local pharmacies doesn't have eRx yet.More and more Medicare are using mail-in meds - some of these mail-in pharmacies don't have eRx yet.

And sometimes, we get a Telecon for a refill and we use eRx to refill a medicine for the patient, but I haven't figured out if we can send a claim into Medicare with only a G8553 code and no other visit code.

How are others handling this?

Locke, MD

I wasn't clear on my original post -- I was curious about the total # of patients that have to be reported during the year - not the CPT code (G8553)

I understand we can only try for one of the incentive plans -- but wasn't there some mention that if we didn't prove we are using eRx, we could get docked on Medicare pay for next year?

Does anyone understand this?

I got the impression that even if you weren't going for incentive pay for the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in 2012..

================

Further googling suggests...

http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

Since 2009, the Centers for Medicare and Medicaid Services has offered an incentive for eligible professionals (EP) to implement and use electronic prescribing (eRx) in order to improve the quality, efficiency and safety of healthcare delivered to beneficiaries. This initiative will continue in 2011 with successful e-prescribers earning a bonus of 1% of their total allowed charges for professional services covered by the Medicare Part B Physician Fee Schedule. However, for the first time, the 2011 eRx program now includes a payment-adjustment or penalty component. EPs who do not implement and use an eRx system in 2011 will be penalized in 2012 and 2013 through a cut to their Medicare payments! You have only until June 30, 2011 to avoid a 1 % cut in your 2012 allowable Physician Fee Schedule billings and until December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings! A full description of the 2011 eRx incentive program and

related penalties is available at http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf.

Even if you are planning to participate in the e-prescribing incentive program and/or the EHR incentive program, you can still be liable for the cut. The only way to avoid the 2012 cut is to file Medicare claims that document 10 qualifying e-prescription events prior to June 30, 2011 â€“ only a few months from now. While you may plan to meet the incentive requirements by the end of 2011 via claims or any other method, be certain that you successfully file your 10 claims before the end of June.

To avoid the 2013 penalty of 1 Â½ % of total allowed charged under Medicare Part B, you will need to file Medicare claims that document 25 qualifying e-prescription events prior to December 31, 2011. Thus, you may want to file the full 25 claims as soon as possible to avoid all eRx related penalties for both 2012 and 2013.

==============================

Good article from ACP here..

http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

==================================

Excellent review here...

Understanding the basics of Medicareâ€™s Electronic Prescribing Incentive Program

http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

====================================

http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

=========================

http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

============================

http://www.healthdatamanagement.com/news/cms-e-prescribing-pqri-conference-call-42079-1.html

CMS to Explain PQRI, E-Prescribing Programs

HDM Breaking News, February 28, 2011

The Centers for Medicare and Medicaid Services will conduct a conference call and simultaneous Web seminar on March 8 to discuss the 2011 Physician Quality Reporting System and Electronic Prescribing Incentive Program.

Participants not participating in the Web seminar are encouraged to download the presentation for the conference call in advance at cms.gov/PQRI/04_CMSSponsoredCalls.asp.

Registration is available at eventsvc.com/palmettogba/030811. Registration will close on March 7 or sooner if space is filled. Additional information on the reporting and e-prescribing incentive programs is available at cms.gov/pqri and cms.gov/erxincentive.

=========================================

http://www.cms.gov/erxincentive/

Electronic Prescribing (eRx) Incentive Program

Click on the "Spotlight" link to the left to view

"What's New" (recently posted items) for the eRx Incentive Program

Background. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for eligible professionals (EPs) who are successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI). Eligible professionals do not need to participate in PQRI to participate in the Electronic Prescribing (eRx) Incentive Program.

For each program year, CMS implements the eRx Incentive Program through an annual rulemaking process published in the Federal Register. Information regarding the relevant statutes and regulations can be found by clicking on the "Statutes/Regulations" section page to the left.

A list of professionals eligible to participate in the eRx Incentive Program is available by clicking on the "Eligible Professionals" link at left.

No Sign Up or Pre-Registration

There is no sign-up or pre-registration to for individual EPs to participate in the eRx Incentive Program. However, there are certain limitations for who can qualify for an eRx incentive payment. First, an EP must have and use a qualified eRx system and report on his or her adoption and use of the eRx system. Second, the EP must meet the criteria for successful electronic prescriber specified by CMS for a particular reporting period. Finally, at least 10% of a successful electronic prescriber's Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure.

Note: The eRx Incentive Program requirements and measure specifications for the current program year may be different from the eRx Incentive Program requirements and measure specifications for a prior year. EPs are responsible for ensuring that they are using the eRx incentive documents for the correct program year.

2010 eRx Incentive Program

To participate in the 2010 eRx Incentive program, individual EPs may choose to report on their adoption and use of a qualified eRx system by submitting information on one eRx measure: (1) to CMS on their Medicare part B claims, (2) to a qualified registry, or (3) to CMS via a qualified electronic health record (EHR) product. Additional information on the registry-based or EHR-based reporting mechanism for the eRx Incentive Program is available by clicking on the "Alternative Reporting Mechanisms" link at left.

To be considered a successful electronic prescriber for the 2010 eRx Incentive Program and potentially qualify to earn a 2.0% incentive payment for the 2010 eRx Incentive Program, an individual EP must report the eRx measure for at least 25 unique electronic prescribing events in which the measure is reportable by the EP during 2010.

Beginning with the 2010 eRx Incentive Program, a group practice may also potentially qualify to earn an eRx incentive payment equal to 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the 2010 eRx reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS. Click on the "Group Practice Reporting Option" link at left to learn more about this reporting option and to obtain instructions on how a group practice can sign up to participate in this reporting option.

2009 eRx Incentive Program

To participate in the 2009 eRx Incentive Program, individual EPs must report on their adoption and use of a qualified eRx system by submitting claims information on one eRx measure on their Medicare Part B claims. To be considered a successful electronic prescriber for 2009 and potentially qualify to earn a 2.0% incentive payment for the 2009 eRx Incentive Program, an individual EP must report the eRx measure in at least 50% of the cases in which the measure is reportable by the EP during 2009.

Information on the eRx measure can be found by clicking on the "eRx Measure" section page to the left.

Additional resources to help EPs become successful electronic prescribers can be found by clicking on the "Educational Resources" section page to the left.

To find out who to contact with questions regarding the eRx Incentive Program, click on the "Help Desk Support" link at left.

============================

http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf on the CMS website for more information; or download the Medicareâ€™s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.

If an eligible professional or selected group practice wishes to request an exemption to the eRx Incentive Program and the payment adjustment, there are two "hardship codes" that can be reported via claims should one of the following situations apply:

â€¢ G8642 - The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

â€¢ G8643 - The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act

Additionally, there will be a G code which can be used by eligible professionals to indicate that they do not have prescribing privileges. Reporting this G code will prevent the eligible professional from being subjected to a payment adjustment in 2012.

========================================

====================================================

PQRI info is...

http://www.cms.gov/pqri/

Locke, MD

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April 14, 2011

,They don't have to price the meaningful use as one price. Many of the EMR vendors have been offering what is now required for years. To do an entire price restructure when they've been exerting the majority of their energy not only programming their system to meet MU requirements but also understanding the rules for us as users so that they can teach us how to report the rules is more important, in my mind. I'm sure that eventually they will change their price structures, but as long as they are providing all the pricing, I don't see a problem with it.

, Is eRx an added cost with your EMR? I assumed it was free or at least a hidden cost since they likely sell information about us to pharmaceutical companies and who knows for what other purposes. Iâ€™m imagining itâ€™s a great way for attorneys to scoop up information for law suits. Does your eRx agreement offer an opt out option about sharing/selling your prescribing information? Got a news release from Practice Fusion yesterday announcing free eRx. No mention of formularies but claimed 65,000 pharmacies. Seems like several others offered free eRx in the past (Allscripts, NuNova). From a practical standpoint the only eRx that makes sense is the one our EMR vendor offers. Also curious what the story is on size of formulary files that have to be stored and backed up locally? Are any EMR vendors pricing eRx as an additional charge with their â€œmeaningful useâ€ upgrades? Seems like it has to be part of the basic package to be â€œmeaningfulâ€. Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR/Billing since 2009 From: [mailto: ] On Behalf Of BleiweissSent: Wednesday, April 13, 2011 10:46 PMTo: ; Practice Management Issues; Bruce Bowen, MD; Dr. Borchers; Dr. Niebur; Glenn Kotz; Kim Scheuer; Ann Mass; Check; Dr. Zimet; Locke; LockeSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 , I was just re-reading the interface with AC for E-Rx'ing and here is part of the service. E-Rx service ala SureScripts should be able to accept your E-Rx as sent to their server (again they are sort of a middleman getting a bit from everybody involved, great deal for them.... Was just share a good vent bitch with a Psychiatrist about why should we have to pay for a service that is really more in the interest of all the other players in this system as opposed to us.... Hand them the Rx at time of service, fax it, mail it whatever) where it is then their job as the middleman here to get to the right guy on the other side of the transmission to then fill the Rx for us and the patient... So as stated right on the AC website is something just like this: and for those pharmacies that do not yet participate with E-Rx'ing we will fax the script to those places.... So as far as I'm concerned once we do our part enter it in the EMR and hit send or transmit and perhaps get a confirmation from SureScripts that it has been recieved, at that point it is no longer our problem, We "Transmitted" the script properly to the first part of the system and after that it is out of our hands... Chain of custody like, we carried it as far as we were allowed or able, and now we properly passed the batton to the next guy in-line, the next one in the food chain to then properly do his part from there.... This should certainly count.... It would be like banging us for not doing something that is out of our control post transfer of care, referal like at someone else's office.... Like I sent them the referal and gave them the Auth Number I properly got from the carrier too... What they did with it on their side after I did what was within my control I have no idea.... http://amazingcharts.com/services/interfaces/eprescribing/ ePrescribing, Powered by NewCrop, a SureScripts Certified SolutionAmazing Charts provides a state-of-the-art integrated ePrescribing solution. This feature is included at no additional charge for users who subscribe to our annual maintenance service (in Amazing Charts V5 and above). Amazing Charts ePrescribing includes:Comprehensive medication information from Lexi-Comp, including Drug/Drug and Drug/Allergy interactionsTwo-way electronic connectivity to pharmacies via the Surescripts Electronic Prescribing Networkâ„¢ For those pharmacies that are not a part of the Surescripts Electronic Prescribing Networkâ„¢, we provide nationwide faxingComprehensive managed care formulary from MediMedia and RxHubMedicare Part D FormulariesPractice-wide refill management from one screenPatient medication hand-outs (in 18 languages)Because of the need to control and verify users of e-prescribing, only registered Amazing Charts' users can activate e-prescribing features. Once registered, you can activate this feature under the Administration section of Amazing Charts. If you have any problems activating the service, please contact us at here. *Please be sure to review the Amazing Charts license agreement on this, and our other services. Amazing Charts offers a number of optional services that will maximize your practice efficiency while lowering your expenses. Only licensed users who are verified may use our prescribing features. Users/Practices still in their trial period are not able to use these prescribing features. To: ; Practice Management Issues ; "Bruce Bowen, MD" ; Dr. Borchers ; Glenn Kotz ; Ann Mass ; Dr. Zimet ; Locke Sent: Wed, April 13, 2011 10:31:42 PMSubject: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 I imagine we will be able to meet the June cutoff for 10 claims, but is anyone frustrated that there isn't a code (is there?) for when the patient chooses to use a pharmacy that doesn't have eRx capability? One of our local pharmacies doesn't have eRx yet.More and more Medicare are using mail-in meds - some of these mail-in pharmacies don't have eRx yet.And sometimes, we get a Telecon for a refill and we use eRx to refill a medicine for the patient, but I haven't figured out if we can send a claim into Medicare with only a G8553 code and no other visit code. How are others handling this? Locke, MDI wasn't clear on my original post -- I was curious about the total # of patients that have to be reported during the year - not the CPT code (G8553) I understand we can only try for one of the incentive plans -- but wasn't there some mention that if we didn't prove we are using eRx, we could get docked on Medicare pay for next year? Does anyone understand this? I got the impression that even if you weren't going for incentive pay for the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in 2012..================Further googling suggests... http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdfSince 2009, the Centers for Medicare and Medicaid Services has offered an incentive for eligible professionals (EP) to implement and use electronic prescribing (eRx) in order to improve the quality, efficiency and safety of healthcare delivered to beneficiaries. This initiative will continue in 2011 with successful e-prescribers earning a bonus of 1% of their total allowed charges for professional services covered by the Medicare Part B Physician Fee Schedule. However, for the first time, the 2011 eRx program now includes a payment-adjustment or penalty component. EPs who do not implement and use an eRx system in 2011 will be penalized in 2012 and 2013 through a cut to their Medicare payments! You have only until June 30, 2011 to avoid a 1 % cut in your 2012 allowable Physician Fee Schedule billings and until December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings! A full description of the 2011 eRx incentive program and related penalties is available at http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf. Even if you are planning to participate in the e-prescribing incentive program and/or the EHR incentive program, you can still be liable for the cut. The only way to avoid the 2012 cut is to file Medicare claims that document 10 qualifying e-prescription events prior to June 30, 2011 â€“ only a few months from now. While you may plan to meet the incentive requirements by the end of 2011 via claims or any other method, be certain that you successfully file your 10 claims before the end of June. To avoid the 2013 penalty of 1 Â½ % of total allowed charged under Medicare Part B, you will need to file Medicare claims that document 25 qualifying e-prescription events prior to December 31, 2011. Thus, you may want to file the full 25 claims as soon as possible to avoid all eRx related penalties for both 2012 and 2013. ==============================Good article from ACP here..http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf==================================Excellent review here...Understanding the basics of Medicareâ€™s Electronic Prescribing Incentive Program http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf====================================http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/=====3

April 14, 2011

My EMR is Welford chart notes They did add a yearly charge for e presribing I bargained it down some as I am a small practice.Added 60.00 a monthI paid $2500.00 for the emr 6 yr sago and pay 620.00/yrin updates and support a year Support is superb

Jean

,They don't have to price the meaningful use as one price. Many of the EMR vendors have been offering what is now required for years. To do an entire price restructure when they've been exerting the majority of their energy not only programming their system to meet MU requirements but also understanding the rules for us as users so that they can teach us how to report the rules is more important, in my mind. I'm sure that eventually they will change their price structures, but as long as they are providing all the pricing, I don't see a problem with it.

, Is eRx an added cost with your EMR? I assumed it was free or at least a hidden cost since they likely sell information about us to pharmaceutical companies and who knows for what other purposes. I’m imagining it’s a great way for attorneys to scoop up information for law suits. Does your eRx agreement offer an opt out option about sharing/selling your prescribing information?

Got a news release from Practice Fusion yesterday announcing free eRx. No mention of formularies but claimed 65,000 pharmacies. Seems like several others offered free eRx in the past (Allscripts, NuNova). From a practical standpoint the only eRx that makes sense is the one our EMR vendor offers.

Also curious what the story is on size of formulary files that have to be stored and backed up locally?

Are any EMR vendors pricing eRx as an additional charge with their “meaningful use” upgrades? Seems like it has to be part of the basic package to be “meaningful”.

Neighbors, MDHuntsville, Alabama

Solo using FlexMedical EMR/Billing since 2009

From: [mailto: ] On Behalf Of Bleiweiss

Sent: Wednesday, April 13, 2011 10:46 PMTo: ; Practice Management Issues; Bruce Bowen, MD; Dr. Borchers; Dr. Niebur; Glenn Kotz; Kim Scheuer; Ann Mass; Check; Dr. Zimet; Locke; Locke

Subject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

, I was just re-reading the interface with AC for E-Rx'ing and here is part of the service. E-Rx service ala SureScripts should be able to accept your E-Rx as sent to their server (again they are sort of a middleman getting a bit from everybody involved, great deal for them.... Was just share a good vent bitch with a Psychiatrist about why should we have to pay for a service that is really more in the interest of all the other players in this system as opposed to us.... Hand them the Rx at time of service, fax it, mail it whatever) where it is then their job as the middleman here to get to the right guy on the other side of the transmission to then fill the Rx for us and the patient... So as stated right on the AC website is something just like this: and for those pharmacies that do not yet participate with E-Rx'ing we will fax the script to those places....

So as far as I'm concerned once we do our part enter it in the EMR and hit send or transmit and perhaps get a confirmation from SureScripts that it has been recieved, at that point it is no longer our problem, We " Transmitted " the script properly to the first part of the system and after that it is out of our hands... Chain of custody like, we carried it as far as we were allowed or able, and now we properly passed the batton to the next guy in-line, the next one in the food chain to then properly do his part from there.... This should certainly count.... It would be like banging us for not doing something that is out of our control post transfer of care, referal like at someone else's office.... Like I sent them the referal and gave them the Auth Number I properly got from the carrier too... What they did with it on their side after I did what was within my control I have no idea....

http://amazingcharts.com/services/interfaces/eprescribing/

ePrescribing, Powered by NewCrop, a SureScripts Certified Solution

Amazing Charts provides a state-of-the-art integrated ePrescribing solution. This feature is included at no additional charge for users who subscribe to our annual maintenance service (in Amazing Charts V5 and above).

Amazing Charts ePrescribing includes:Comprehensive medication information from Lexi-Comp, including Drug/Drug and Drug/Allergy interactions

Two-way electronic connectivity to pharmacies via the Surescripts Electronic Prescribing Network™ For those pharmacies that are not a part of the Surescripts Electronic Prescribing Network™, we provide nationwide faxing

Comprehensive managed care formulary from MediMedia and RxHubMedicare Part D FormulariesPractice-wide refill management from one screen

Patient medication hand-outs (in 18 languages)Because of the need to control and verify users of e-prescribing, only registered Amazing Charts' users can activate e-prescribing features. Once registered, you can activate this feature under the Administration section of Amazing Charts. If you have any problems activating the service, please contact us at here.

*Please be sure to review the Amazing Charts license agreement on this, and our other services. Amazing Charts offers a number of optional services that will maximize your practice efficiency while lowering your expenses. Only licensed users who are verified may use our prescribing features. Users/Practices still in their trial period are not able to use these prescribing features.

To: ; Practice Management Issues ; " Bruce Bowen, MD " ; Dr. Borchers ; Glenn Kotz ; Ann Mass ; Dr. Zimet ; Locke

Sent: Wed, April 13, 2011 10:31:42 PMSubject: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

I imagine we will be able to meet the June cutoff for 10 claims, but is anyone frustrated that there isn't a code (is there?) for when the patient chooses to use a pharmacy that doesn't have eRx capability?

One of our local pharmacies doesn't have eRx yet.More and more Medicare are using mail-in meds - some of these mail-in pharmacies don't have eRx yet.

And sometimes, we get a Telecon for a refill and we use eRx to refill a medicine for the patient, but I haven't figured out if we can send a claim into Medicare with only a G8553 code and no other visit code.

How are others handling this? Locke, MD

I wasn't clear on my original post -- I was curious about the total # of patients that have to be reported during the year - not the CPT code (G8553)

I understand we can only try for one of the incentive plans -- but wasn't there some mention that if we didn't prove we are using eRx, we could get docked on Medicare pay for next year?

Does anyone understand this? I got the impression that even if you weren't going for incentive pay for the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in 2012..

================Further googling suggests... http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

Since 2009, the Centers for Medicare and Medicaid Services has offered an incentive for eligible professionals (EP) to implement and use electronic prescribing (eRx) in order to improve the quality, efficiency and safety of healthcare delivered to beneficiaries. This initiative will continue in 2011 with successful e-prescribers earning a bonus of 1% of their total allowed charges for professional services covered by the Medicare Part B Physician Fee Schedule. However, for the first time, the 2011 eRx program now includes a payment-adjustment or penalty component. EPs who do not implement and use an eRx system in 2011 will be penalized in 2012 and 2013 through a cut to their Medicare payments! You have only until June 30, 2011 to avoid a 1 % cut in your 2012 allowable Physician Fee Schedule billings and until December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings! A full description of the 2011 eRx incentive program and related penalties is available at http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf.

Even if you are planning to participate in the e-prescribing incentive program and/or the EHR incentive program, you can still be liable for the cut. The only way to avoid the 2012 cut is to file Medicare claims that document 10 qualifying e-prescription events prior to June 30, 2011 – only a few months from now. While you may plan to meet the incentive requirements by the end of 2011 via claims or any other method, be certain that you successfully file your 10 claims before the end of June.

To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare Part B, you will need to file Medicare claims that document 25 qualifying e-prescription events prior to December 31, 2011. Thus, you may want to file the full 25 claims as soon as possible to avoid all eRx related penalties for both 2012 and 2013.

==============================Good article from ACP here..http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

==================================Excellent review here...Understanding the basics of Medicare’s Electronic Prescribing Incentive Program http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

====================================http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

=====3

-- MD ph fax

April 15, 2011

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> > > ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 15, 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >

> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> >

> ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

April 15, 2011

Not that I'm aware of.....

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> > > ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 15, 2011

from http://www.cms.gov/ERxIncentive/08_Alternative%20Reporting%20Mechanism.asp#TopOfPage

Not that I'm aware of.....

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >

> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> >

> ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

April 15, 2011

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >

> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> >

> ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

April 15, 2011

i had to pay like 150 bucks (which is dirt cheap for allscripts) to be setup for mail order erx, formulary info and med tracking (it's called Rx Hub in my system) - unfortunately only 2 of my common 4 mail order pharmacies seem to allow Erx (caremark and medco) whereas prescription solutions, human right source and a couple other ones dont

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >

> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> >

> ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

April 18, 2011

I reviewed the MU rules for e-rx (have them right in front of me). Formularies are definitely not part of the measure. The denominator is " number of rx written for drugs requiring an rx in order to be dispensed other than controlled substances during the EHR reporting period. " The numerator is " number of rx's in the denominator generated and transmitted electronically. " The measure is " more than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. "

There is a separate, MENU SET item that is " implement drug formulary checks. " We have chosen not to do this measure.

Regarding the e-rx reporting, you do not have to have a system that has formularies as long as you provide " information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available. "

The way I read this, as long as you receive the formulary in some sort of electronic version and offer that information to the patient, you do not need to have formularies built into the system. We can access formularies online for most of our insurance plans, so I'm hoping that qualifies us. Regardless, we won't qualify for the e-rx bonus because we are going to qualify for MU. We are just trying to avoid penalties in 2012 by reporting it now.

i had to pay like 150 bucks (which is dirt cheap for allscripts) to be setup for mail order erx, formulary info and med tracking (it's called Rx Hub in my system) - unfortunately only 2 of my common 4 mail order pharmacies seem to allow Erx (caremark and medco) whereas prescription solutions, human right source and a couple other ones dont

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> > > ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 18, 2011

agree formularies are NOT part of meaningful usebut are certainly part of what constitues a qualified erx system WHICH SHOULD DO ALL 4 of the requirements

I reviewed the MU rules for e-rx (have them right in front of me). Formularies are definitely not part of the measure. The denominator is " number of rx written for drugs requiring an rx in order to be dispensed other than controlled substances during the EHR reporting period. " The numerator is " number of rx's in the denominator generated and transmitted electronically. " The measure is " more than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. "

There is a separate, MENU SET item that is " implement drug formulary checks. " We have chosen not to do this measure.

Regarding the e-rx reporting, you do not have to have a system that has formularies as long as you provide " information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available. "

The way I read this, as long as you receive the formulary in some sort of electronic version and offer that information to the patient, you do not need to have formularies built into the system. We can access formularies online for most of our insurance plans, so I'm hoping that qualifies us. Regardless, we won't qualify for the e-rx bonus because we are going to qualify for MU. We are just trying to avoid penalties in 2012 by reporting it now.

i had to pay like 150 bucks (which is dirt cheap for allscripts) to be setup for mail order erx, formulary info and med tracking (it's called Rx Hub in my system) - unfortunately only 2 of my common 4 mail order pharmacies seem to allow Erx (caremark and medco) whereas prescription solutions, human right source and a couple other ones dont

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >

> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >

> >

> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?

> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in

> > 2012..> >> > ================> >> > Further googling suggests...> >> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> >

> ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

1 of 1 File(s)

2011_EHR_Measure_Specification_for_eRx_July2010-070110.pdf

April 18, 2011

40% is for Meaningful Use. That is completely separate from the 10 scripts needed for the e-rx incentive. These are two separate (but similar) issues.

So I'm a bit confused. Originally I thought I only had to do 10 scripts but now I'm seeing 40%? So like someone else on the list serve I've got to go back to January and find all those that I send by e-script?

To:

Sent: Mon, April 18, 2011 2:10:46 PMSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 [1 Attachment]

agree formularies are NOT part of meaningful usebut are certainly part of what constitues a qualified erx system WHICH SHOULD DO ALL 4 of the requirements

I reviewed the MU rules for e-rx (have them right in front of me). Formularies are definitely not part of the measure. The denominator is " number of rx written for drugs requiring an rx in order to be dispensed other than controlled substances during the EHR reporting period. " The numerator is " number of rx's in the denominator generated and transmitted electronically. " The measure is " more than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. "

There is a separate, MENU SET item that is " implement drug formulary checks. " We have chosen not to do this measure.

Regarding the e-rx reporting, you do not have to have a system that has formularies as long as you provide " information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available. "

The way I read this, as long as you receive the formulary in some sort of electronic version and offer that information to the patient, you do not need to have formularies built into the system. We can access formularies online for most of our insurance plans, so I'm hoping that qualifies us. Regardless, we won't qualify for the e-rx bonus because we are going to qualify for MU. We are just trying to avoid penalties in 2012 by reporting it now.

i had to pay like 150 bucks (which is dirt cheap for allscripts) to be setup for mail order erx, formulary info and med tracking (it's called Rx Hub in my system) - unfortunately only 2 of my common 4 mail order pharmacies seem to allow Erx (caremark and medco) whereas prescription solutions, human right source and a couple other ones dont

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (

> > G8553)> >> >> >> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get

> > docked on Medicare pay for next year?> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for

> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in> > 2012..> >> > ================> >> > Further googling suggests...> >> >

> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a

> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A

> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that

> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain

> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying

> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >

> > ==============================> >> > Good article from ACP here..> >> >> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> > > ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 18, 2011

Thanks. I do prefer to try for Meaningful Use.

To: Sent: Mon, April 18, 2011 4:15:57 PMSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

40% is for Meaningful Use. That is completely separate from the 10 scripts needed for the e-rx incentive. These are two separate (but similar) issues.

So I'm a bit confused. Originally I thought I only had to do 10 scripts but now I'm seeing 40%? So like someone else on the list serve I've got to go back to January and find all those that I send by e-script?

To: Sent: Mon, April 18, 2011 2:10:46 PMSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 [1 Attachment]

agree formularies are NOT part of meaningful usebut are certainly part of what constitues a qualified erx system WHICH SHOULD DO ALL 4 of the requirements

I reviewed the MU rules for e-rx (have them right in front of me). Formularies are definitely not part of the measure. The denominator is "number of rx written for drugs requiring an rx in order to be dispensed other than controlled substances during the EHR reporting period." The numerator is "number of rx's in the denominator generated and transmitted electronically." The measure is "more than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology."

There is a separate, MENU SET item that is "implement drug formulary checks." We have chosen not to do this measure.

Regarding the e-rx reporting, you do not have to have a system that has formularies as long as you provide "information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available."

The way I read this, as long as you receive the formulary in some sort of electronic version and offer that information to the patient, you do not need to have formularies built into the system. We can access formularies online for most of our insurance plans, so I'm hoping that qualifies us. Regardless, we won't qualify for the e-rx bonus because we are going to qualify for MU. We are just trying to avoid penalties in 2012 by reporting it now.

i had to pay like 150 bucks (which is dirt cheap for allscripts) to be setup for mail order erx, formulary info and med tracking (it's called Rx Hub in my system) - unfortunately only 2 of my common 4 mail order pharmacies seem to allow Erx (caremark and medco) whereas prescription solutions, human right source and a couple other ones dont

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a "menu set" item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this. Haresch> >> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (> > G8553)> >> >> >> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get> > docked on Medicare pay for next year?> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in> > 2012..> >> > ================> >> > Further googling suggests...>

>> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or

penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A> > full description of the 2011 eRx incentive program and related penalties is> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for

the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that> > document 10 qualifying e-prescription events prior to June 30, 2011 â€“ only a> > few months from now*. While you may plan to meet the incentive> > requirements by the end of 2011 via claims or any other method, be certain> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 Â½ % of total allowed charged under Medicare> > Part B, you will need to file Medicare claims that document 25 qualifying> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties> > for both 2012 and 2013.> >> > ==============================> >> > Good article from ACP here..> >>

>> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/> >> > =====3> >> > > >> > > > -- > > > > MD> > > ph fax > >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 18, 2011

but if you dont use the g code for 10 encounters by june30...the penalty will apply...

Thanks. I do prefer to try for Meaningful Use.

To:

Sent: Mon, April 18, 2011 4:15:57 PMSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

40% is for Meaningful Use. That is completely separate from the 10 scripts needed for the e-rx incentive. These are two separate (but similar) issues.

So I'm a bit confused. Originally I thought I only had to do 10 scripts but now I'm seeing 40%? So like someone else on the list serve I've got to go back to January and find all those that I send by e-script?

To:

Sent: Mon, April 18, 2011 2:10:46 PMSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012 [1 Attachment]

agree formularies are NOT part of meaningful usebut are certainly part of what constitues a qualified erx system WHICH SHOULD DO ALL 4 of the requirements

I reviewed the MU rules for e-rx (have them right in front of me). Formularies are definitely not part of the measure. The denominator is " number of rx written for drugs requiring an rx in order to be dispensed other than controlled substances during the EHR reporting period. " The numerator is " number of rx's in the denominator generated and transmitted electronically. " The measure is " more than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. "

There is a separate, MENU SET item that is " implement drug formulary checks. " We have chosen not to do this measure.

Regarding the e-rx reporting, you do not have to have a system that has formularies as long as you provide " information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available. "

The way I read this, as long as you receive the formulary in some sort of electronic version and offer that information to the patient, you do not need to have formularies built into the system. We can access formularies online for most of our insurance plans, so I'm hoping that qualifies us. Regardless, we won't qualify for the e-rx bonus because we are going to qualify for MU. We are just trying to avoid penalties in 2012 by reporting it now.

i had to pay like 150 bucks (which is dirt cheap for allscripts) to be setup for mail order erx, formulary info and med tracking (it's called Rx Hub in my system) - unfortunately only 2 of my common 4 mail order pharmacies seem to allow Erx (caremark and medco) whereas prescription solutions, human right source and a couple other ones dont

sorry make that july 2011

Isnt formularies required if we are to use the g code to avoid penalties? ( 10 rx by June 30?)Practice Fusion does erx to mail order pharmacies, say they will have formularies by July 2010...

We only had to pay a one-time set up fee for e-rx. If we want formularies (which we are not doing until it's required - it is currently a " menu set " item), there is another fee with monthly fees associated with it. I'm guessing that they have to pay some sort of subscription fee to Surescripts (or whomever they are using), and they pass that along to the end-users.

Would others share how their EMR vendors are handling this? I just learned that Praxis is going to charge $500 per year for e-prescribing, on top of the $1500 per year I already pay for support. But the the rest of the MU upgrades are included in this.

Haresch> >> > I wasn't clear on my original post -- I was curious about the total # of> > patients that have to be reported during the year - not the CPT code (

> > G8553)> >> >> >> > I understand we can only try for one of the incentive plans -- but wasn't> > there some mention that if we didn't prove we are using eRx, we could get

> > docked on Medicare pay for next year?> >> >> >> > Does anyone understand this?> >> >> >> > I got the impression that even if you weren't going for incentive pay for

> > the eRx - you had to do the codes in 2011 to prevent a Medicare fee cut in> > 2012..> >> > ================> >> > Further googling suggests...>

>> >> >> >> > http://www.cms.gov/ERxIncentive/Downloads/2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment.pdf

> >> > Since 2009, the Centers for Medicare and Medicaid Services has offered an> > incentive for eligible professionals (EP) to implement and use electronic> > prescribing (eRx) in order to improve the quality, efficiency and safety of

> > healthcare delivered to beneficiaries. This initiative will continue in 2011> > with successful e-prescribers earning a bonus of 1% of their total allowed> > charges for professional services covered by the Medicare Part B Physician

> > Fee Schedule. *However, for the first time, the 2011 eRx program now> > includes a payment-adjustment or

penalty component. EPs who do not implement> > and use an eRx system in 2011 will be penalized in 2012 and 2013 through a> > cut to their Medicare payments! You have only until June 30, 2011 to avoid a

> > 1 % cut in your 2012 allowable Physician Fee Schedule billings and until> > December 31, 2011 to avoid a 1 1/2 percent penalty for 2013 billings!* A> > full description of the 2011 eRx incentive program and related penalties is

> > available at> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf[image:

> > [PDF]].> >> > Even if you are planning to participate in the e-prescribing incentive> > program and/or the EHR incentive program, you can still be liable for

the> > cut. *The only way to avoid the 2012 cut is to file Medicare claims that> > document 10 qualifying e-prescription events prior to June 30, 2011 – only a> > few months from now*. While you may plan to meet the incentive

> > requirements by the end of 2011 via claims or any other method, be certain> > that you successfully file your 10 claims before the end of June.> >> > To avoid the 2013 penalty of 1 ½ % of total allowed charged under Medicare

> > Part B, you will need to file Medicare claims that document 25 qualifying> > e-prescription events prior to December 31, 2011. Thus, you may want to file> > the full 25 claims as soon as possible to avoid all eRx related penalties

> > for both 2012 and 2013.> >> > ==============================> >> > Good article from ACP here..> >>

>> > <http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf>

> > http://www.acponline.org/running_practice/technology/eprescribing/medicare_program_overview.pdf

> >> > ==================================> >> > Excellent review here...> >> > *Understanding the basics of Medicare's Electronic Prescribing Incentive> > Program *

> >> >> > http://www.ama-assn.org/ama1/pub/upload/mm/472/faq-cms-incentive-program.pdf

> >> > ====================================> >> >> > http://www.managemypractice.com/e-prescribing-use-it-10-times-for-medicare-patients-between-now-and-june-30-2011-or-lose-money-in-2012/

> >> > =====3> >> > > >> > > > -- > > > > MD> >

> ph fax

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- Sangeetha

April 19, 2011

thanks

To: Sent: Mon, April 18, 2011 4:58:15 PMSubject: Re: eRx an option in EMR, but Mail-in Pharmacy not eRx-able --> Re: eRx for Medicare --> # of patients needed to report in 2011 to avoid penalty in 2012

but if you dont use the g code for 10 encounters by june30...the penalty will apply...

Thanks. I do prefer to try for Meaningful Use.

To: Sent: Mon, April 18, 2011 4:15:57 PM