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Health Information Technology

Health Information Technology (HIT): Resources for Practice

E-Prescribing Resources

AHRQ Toolsets Available to Help Implement E-Prescribing

Two toolsets, one for healthcare providers in small practices and one for independent pharmacies, to support e-prescribing implementation have been released by AHRQ. The toolsets offer a step-by-step guide for preparing for and launching an e-prescribing system. They include advice on topics ranging from planning the implementation process, launching the system, troubleshooting common problems, and navigating into more advanced practice and pharmacy services. Access the toolsets and supporting tools.

2011 Electronic Prescribing Incentive (eRx) Educational Resources

The Centers for Medicare & Medicaid Services (CMS) announced two educational resources on the 2011 Electronic Prescribing Incentive Program are now available on the CMS website.

To access all available Electronic Prescribing Incentive Program educational resources, please visit www.cms.gov/ERxIncentive on the CMS website and click on the Educational Resources tab. Once on the Educational Resources page, scroll down to the “Downloads” section and select the publication title.

2011 Electronic Prescribing (eRx) Incentive Program Reminder-Avoiding the Adjustment

In November 2011, the Centers for Medicare & Medicaid Services announced that, beginning in calendar year 2012, eligible professionals who are not successful electronic prescribers based on claims submitted between January 1, 2011 – June 30, 2011, may be subject to a payment adjustment on their Medicare Part B Physician Fee Schedule (PFS) covered professional services. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes CMS to apply this payment adjustment whether or not the eligible professional is planning to participate in the eRx Incentive Program.

From 2012 through 2014, the payment adjustment will increase each calendar year. In 2012, the payment adjustment for not being a successful electronic prescriber will result in an eligible professional or group practice receiving 99% of their Medicare Part B PFS amount that would otherwise apply to such services. In 2013, an eligible professional or group practice will receive 98.5% of their Medicare Part B PFS covered professional services for not being a successful electronic prescriber in 2011 or as defined in a future regulation. In 2014, the payment adjustment for not being a successful electronic prescriber is 2%, resulting in an eligible professional or group practice receiving 98% of their Medicare Part B PFS covered professional services.

The payment adjustment does not apply if <10% of an eligible professional’s (or group practice’s) allowed charges for the January 1, 2011 through June 30, 2011 reporting period are comprised of codes in the denominator of the 2011 eRx measure.

Please note that earning an eRx incentive for 2011 will NOT necessarily exempt an eligible professional or group practice from the payment adjustment in 2012.

How to Avoid the 2012 eRx Payment Adjustment

Eligible professionals – An eligible professional can avoid the 2012 eRx Payment Adjustment if (s)he:

  • Is not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of June 30, 2011 based on primary taxonomy code in NPPES;
  • Does not have prescribing privileges. Note: (S)he must report (G8644) at least one time on an eligible claim prior to June 30, 2011;
  • Does not have at least 100 cases containing an encounter code in the measure denominator;
  • Becomes a successful e-prescriber; and
  • Reports the eRx measure for at least 10 unique eRx events for patients in the denominator of the measure.

Group Practices - For group practices that are participating in eRx GPRO I or GPRO II during 2011, the group practice MUST become a successful e-prescriber.

  • Depending on the group’s size, the group practice must report the eRx measure for 75-2,500 unique eRx events for patients in the denominator of the measure.
Electronic Health Record (EHR) Resources

AHRQ, CMS Annouce Children’s Electronic Health Record Format

The benefits of electronic health records (EHRs) may become more widely available to children through a model EHR format for children’s health care, AHRQ and CMS announced on February 6, 2013. While the growing use of EHRs is shown to improve the quality and safety of health care, many existing systems are not tailored to capture or process information about children. The new format includes recommendations for child-specific data elements such as vaccines and functionality that will enable EHR developers to broaden their products. The children’s EHR format was authorized by the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) and developed by AHRQ and CMS. The format is designed for EHR developers and providers who wish to augment existing systems or to build new systems that include children’s services. Read details from the AHRQ press release. Find more information about the children’s EHR format. Find more information about Medicaid and CHIP.

Want more information about the EHR Incentive Programs?

Make sure to visit the CMS EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs. The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals and hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology. Bookmark this site and visit http://www.cms.gov/EHRIncentivePrograms/ often to learn about who is eligible for the programs, how to register, meaningful use, upcoming EHR training and events, and much more!