Meaningful Use Mondays – ePrescribing Penalties and MIPPA

No Matter What Else You Do in 2011, You’ve Got to ePrescribe

With all of the focus on meeting meaningful use, the requirements related to ePrescribing under the Medicare MIPPA program seem to be getting lost in the shuffle. Just as some practices didn’t get the message about the 2010 change in ePrescribing G-codes until late in the year, I am hearing that the communication hasn’t reached everyone about the importance of ePrescribing in 2011; so I thought I would post a reminder:

2011 ePrescribing activity will be the basis for the 2012 and 2013 ePrescribing Medicare penalties (AKA “adjustments”) under MIPPA. If you are not already ePrescribing, it’s important to start very soon. The following are the rules:

  • ePrescribe on 10 Medicare encounters between now and June 30, 2011 to avoid a 1% reduction in 2012 Medicare rates.
  • ePrescribe on 25 Medicare encounters between now and December 31, 2011 to avoid a 1.5% adjustment in 2013.
  • By ePrescribing 25 times, you can also earn the 1% ePrescribing incentive in 2011.

Note, however, that the legislation does not allow providers to collect both the ePrescribing and EHR incentives (as a Medicare provider) in the same year, so you must make a choice: Collect the MIPPA incentive in 2011 and start pursuing meaningful use in 2012—a strategy discussed by Evan Steele in EMR Straight Talk—or forego the MIPPA incentive in 2011 and attest to meaningful use in 2011. In either case, you must continue to comply with MIPPA requirements to avoid the future penalties associated with that program.

Lynn Scheps is Vice President, Government Affairs at EMR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

About the author

Lynn Scheps

Lynn Scheps

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

14 Comments

  • Thanks – good relevant, timely info.

    One question, since I”m new to the regulatory process:

    You refer to “the legislation.” But my impression is that everything about these rules wasn’t in the bill passed by Congress (ARRA/HITECH), it was in the regulations subsequently created by HHS to fulfill the law. Yes?

    I have the impression that there’s not much difference – the regs have the effect of law – but since I’m new to this, I’m testing my understanding.

  • Actually, it is in both the HITECH ACT (ARRA) and on page 44442 of the Final Rule on the EHR Incentive Program in the Federal Register:

    “7. Interaction With Other Programs In the proposed rule, we described how the HITECH Act addresses interactions between the Medicare EHR incentive program and the E-prescribing Incentive Program authorized by MIPPA. Under section 1848(m)(2)(D) of the Act, as added by section 4101(f)(2)(B) of the HITECH Act, if a Medicare FFS or MA EP receives an incentive payment from the Medicare EHR incentive program, the EP (or group practice) is not eligible to also receive the incentive payment under the E-prescribing Incentive Program created by MIPPA.”

  • Thank you! Your site always has great information!!

    A couple of questions: 1) Is the reference to “25 e-prescriptions” per physician? 2) Are the 2012 and 2013 penalties per physician?

    I’m trying to determine if some physicians in the practice can “opt out” (just as they could for meaningful use)

  • Hey Lynn,
    At HIMSS I had it pointed out to me that someone could potentially get the eRx incentive, but still get the penalty as well. Say they ePrescribe 25 after 6/30 then this would be the case. Kind of a funny part of the legislation.

    Christy,
    My understanding is that it is per provider similar to the EHR incentive money.

  • Brett,
    There is no official “opt out” from the ePrescribing incentives; you simply don’t participate. If you are talking about requesting an exemption from the 2012 ePrescribing penalties and feel that you fit one of the exemption categories, the process is outlined in my recent post, “Exemption from 2012 eRx penalties: The Process is Now in Place.” https://www.healthcareittoday.com/2011/09/19/
    Lynn

  • Hi Lynn,

    I am working with a physician who has implemented a certified EMR and is using it meaningfully but is not meeting the 40% e-prescriptions requirement because a majority of is patients are in nursing homes and the prescriptions are filled in-house and the onsite pharmacies do not have e-prescribing set up. Is there a second exclusion or is there a way to request a special exclusion? If so can you explain the process? Thank you.

    Keri

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