E-Prescribing Benefits

E-prescribing is the electronic method of generating prescriptions by using a system that transmits scripts to participating pharmacies electronically

What are the Incentives/Penalties?

Beginning January 1, 2009, providers who use a qualified system to e-prescribe can receive a higher level of reimbursement under Medicare in the form of a 2% reimbursement bonus in 2009 and 2010. That reimbursement bonus will drop to 1% in 2011 and 2012 and to .5% in 2013. Also, eligible providers who do not e-prescribe will see a penalty of 1% in their reimbursement starting in 2012. The penalty increases to 1.5% in 2013 and to 2% in 2014 and beyond

Year	Incentive	Penalty
2009	2%	None
2010	2%	None
2011	1%	None
2012	1%	1%
2013	0.5%	1.5%
Beyond	None	2%

Who is Eligible?

For the 2009 e-prescribing reporting year, to be a successful e-prescriber and qualify to receive an incentive payment, an eligible professional must use a “qualified” e-prescribing system to report one e-prescribing measure in at least 50- of eligible cases (the cases in which the measure is reportable by the eligible professional) during 2009 and at least 10- of the eligible professional´s total Medicare Part B allowed charges for 2009 are from covered services listed in the denominator of the measure.

Under the E-Prescribing Incentive Program, covered professional services are those paid under the Medicare Physician Fee Schedule (PFS). To the extent that eligible professionals are providing services which are paid under the PFS, those services are eligible for E-Prescribing Incentive Program.

What does E-prescription do?

To meet the requirements of a “qualified e-prescribing system” an EMR System should include the following tasks:

Generates a complete active medication list using electronic data received from applicable pharmacies and pharmacy benefit managers (PBM), if available.
Allows providers to select medications and transmit prescriptions electronically, alerting the prescriber of drug-drug interactions, allergy concerns, or other unsafe or undesirable situations
Provides information on lower cost alternatives
Provides information on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan
Meets the Part D specifications for messaging that were implemented on April 1, 2009.

Benefits to Providers (Summary)

Safe and timely delivery of prescriptions
Point-of-care access to patient’s eligibility and formulary
Reduced errors related to drug-to-drug and drug allergy interactions as well as misread hand-written scripts
Minimize doctor-pharmacy communications
Easier and faster prescription authorization-fulfillment-renewal

Benefits to Providers (Detail)

It allows you to automate the entire prescribing process via SureScripts ®, the country´s largest national electronic prescribing network for the following services and benefits:

Eligibility and Formulary

E-prescription provides prescribers with real-time, electronic access to eligibility and formulary information from patient drug plans.

Benefit:

Enables prescribers to select medications that are on formulary and are covered by the patient’s drug benefit.
Informs prescribers of lower cost alternatives such as generic drugs.
Unnecessary phone calls from pharmacy staff to physician practices related to drug coverage are reduced.

Prescription History

E-prescription allows prescribers to electronically access patient medication history from pharmacies and payers at the point of care.

Benefit:

Access to medication history decreases the risk of preventable medication errors. Prescribers who can access critically important information on their patient´s current and past prescriptions are better informed about potential medication issues with their patients and can use this information to improve safety and quality.

Prescription Routing

E-prescription replaces old, error-prone approaches to sending new prescriptions (i.e. handwritten, printed or faxed prescriptions), with the secure computer-to-computer exchange of prescriptions between prescribers and pharmacies.

New Prescriptions:

It facilitates the electronic transmission of new prescriptions from physician to pharmacist reducing the risk of medication errors associated with poor handwriting, illegible faxes and manual data entry.

Renewals/Refills:

E-prescription enables physicians to electronically receive and respond to renewal requests and refill authorizations from pharmacies saving time and money by dramatically reducing the number of phone calls and faxes typically associated with the prescription renewal authorization process, which could translate into more time for patient care or other reimbursable activity.

Benefit:

By eliminating paper, phone and fax, electronic Prescription Routing makes getting patients the medications they need a safer and more efficient process, resulting in savings in time and money.

Benefits to Patients

Improved Safety- lower medication errors
Increased Convenience-no paper Rx to drop off
Lower Costs- allows prescribers to select medications on drug plan

Meeting CMS Guidelines

As of October 1, 2008, CMS requires all written Medicaid prescriptions to be on a tamper resistant blank. Electronic prescriptions are excluded from this requirement. E-prescriptions are excluded from this requirement.
Beginning January 1, 2012 Part D prescriptions can no longer be sent to pharmacies by computer generated fax. If your EMR or e-prescribing system is not enabled to send prescriptions to pharmacies electronically by this date, prescriptions must be printed and handed to the patient, or manually faxed.