While panel member Dr. Michael Rapp, director of the Centers for Medicare and Medicaid Services Quality Measurement and Health Assessment Group, agreed that the process does require careful consideration, he assured attendees that “most office-based doctors would meet the basic eligibility requirements.”
Chief among these basic requirements are the use of an e-prescribing system that meets the 2009 Medicare Part D standards, which go into effect in April 2009, and properly reporting e-prescribing activity, according to Dr. Rapp.
Under the Physician Quality Reporting Initiative (PQRI) measure No. 125, “qualified” e-prescribing systems must be able to generate a medication list; provide information on lower-cost alternative medications; transmit prescriptions directly to the pharmacy; generate automated alerts offering information on the drug, potential inappropriate dose of route of administration, drug-drug interactions, allergy concerns, and warnings; and provide information on tiered formulary medications, he said.
Whether these criteria are met by a stand-alone e-prescribing system or a full-blown electronic health record (EHR) system with an e-prescribing module does not affect eligibility, said Dr. Rapp. “It is important to think long term when choosing what type of system to buy. Although a full EHR system is not necessary now, it very likely will be a requirement in the future, so think about buying something that will enable the eventual transition to an EHR.”
With respect to documenting e-prescribing activity, physicians must report on the Medicare claim form that they have and use a qualified e-prescribing system, and they must report an encounter with one of several CPT or G-codes specified in the measure (
“Successful reporting,” according to Dr. Rapp, “is defined as reporting the measure on at least 50% of eligible patients.”
Additionally, physicians must receive at least 10% of their total allowed charges for Medicare Part B covered services from these codes, he explained.
The details of the 2009 e-prescribing incentive program were still being tweaked at press time, Dr. Rapp stated.