Tuesday, December 28, 2010

Medicare/Medicaid Electronic health records incentives registration starts Jan. 3, 2011

CMS, ONC Outline Resources to Assist Eligible Providers

Today the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced the availability of registration for the Medicare and Medicaid electronic health record (EHR) incentive programs. CMS and ONC encouraged broad participation and outlined online and in-person resources that are in place to assist eligible professionals and eligible hospitals who wish to participate.

Beginning Jan. 3, 2011, registration will be available for eligible health care professionals and eligible hospitals who wish to participate in the Medicare EHR incentive program. On January 3, registration in the Medicaid EHR Incentive Program will also be available in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. In February, registration will open in California, Missouri, and North Dakota. Other states likely will launch their Medicaid EHR Incentive Programs during the spring and summer of 2011.

“It’s time to get connected,” said David Blumenthal, MD, MPP, National Coordinator for Health Information Technology. “ONC and CMS have worked together over many months to prepare for the startup on January 3rd. ONC’s Certified HIT Product List includes more than 130 certified EHR systems or modules and is updated frequently. ONC also has hands-on assistance available across the country through 62 Regional Extension Centers
We look forward to continuing to work with CMS to assist eligible providers in 2011 and future years.”

Eligible professionals and eligible hospitals must register in order to participate in the Medicare and Medicaid EHR incentive programs. They can do so, starting Jan. 3, 2011, at a registration site maintained by CMS.

To prepare for registration, interested providers should first familiarize themselves with the incentive programs’ requirements by visiting CMS’ Official Web Site for the Medicare and Medicaid EHR Incentive Programs. The site provides general and detailed information on the programs, including tabs on the path to payment, eligibility, meaningful use, certified EHR technology, and frequently asked questions.

For more information please read CMS press release issued today (12/22): https://www.cms.gov/apps/media/press/release.asp?Counter=3887&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Tuesday, December 21, 2010

CMS PQRI Town Hall February 9, 2011

The Centers for Medicare & Medicaid Services (CMS) will host a Town Hall Meeting on February 9, 2011, from 10 a.m. until 4:00 p.m.to discuss the Physician Quality Reporting System (formerly known as the Physician Quality Reporting Initiative, or PQRI). The purpose of the Town Hall Meeting is to solicit input from participating stakeholders on individual quality measures and measures groups being considered for possible inclusion in the proposed set of quality measures for use in the 2012 Physician Quality Reporting System and key components of the design of the Physician Quality Reporting System. The opinions and alternatives provided during this meeting will assist CMS develop the Physician Quality Reporting System for 2012.

Interested parties are invited to participate, either onsite at CMS headquarters in Baltimore, Maryland, or via teleconference. The meeting is open to the public; however attendance is limited to space and teleconference lines available.

CMS anticipates posting an audio download and/or transcript of the Town Hall meeting on the CMS Web site, http://www.cms.hhs.gov/PQRI, on the CMS website and http://www.usqualitymeasures.org, on the internet following the meeting.

The Town Hall Meeting will be held on February 9, 2011, from 10 a.m. until 4:00 p.m. Eastern Standard Time (E.S.T.) in the main auditorium of the Central Building of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244–1850.

Meeting Registration and Request for Special Accommodations Deadline:

Registration opens on Monday, December 20, 2010. For security reasons, registration and requests for special accommodations must be completed no later than 5 p.m. E.S.T. on Friday, January 28, 2011.

Anyone interested in attending the meeting or participating by teleconference must register by completing the online registration at http://www.usqualitymeasures.org on the internet.

For more information, please see the Federal Register meeting notice posted at http://edocket.access.gpo.gov/2010/pdf/2010-31301.pdf on the internet.

To learn more about the 2012 Physician Quality Reporting System Call for Measures, please visit http://www.cms.gov/MMS/13_CallForMeasures.asp#TopOfPage on the CMS website.
NCQA Recognition Programs and the Medicare (CMS) Physicians Quality Reporting Initiative

The Centers for Medicare & Medicaid Services (CMS) designated three NCQA Recognition Programs as registries for quality reporting for the purposes of the Physician Quality Reporting Initiative (PQRI). Providers participating in Medicare's PQRI program receive financial rewards for collecting and reporting practice data about the quality of their care as well as being recognized for their superb care. In 2010, the reward is equal to 2 percent of total allowed Medicare Part B charges for services furnished during 2010.

Clinicians, who have earned Recognition from NCQA through the Diabetes Recognition Program (DRP), the Heart Stroke Recogniton Program (HSRP) or the Back Pain Recognition Program (BPRP), can have NCQA submit their clinical quality data to CMS. To qualify, Recognized clinicians must submit their PQRI qualifying data to NCQA by December 31, 2010.

NCQA is also providing clinicians who are currently applying for or
considering applying for NCQA's DRP, HSRP or BPRP program with submission of their qualifying data to 2010 PQRI registry as an added feature to the Recognition Process.

Make the Most of Your NCQA Recognition!

• For more information about NCQA's PQRI Program,
visit www.ncqa.org/Recognition

• For more information about DRP,
visit www.ncqa.org/drp

• For more information about HSRP,
visit www.ncqa.org/hsrp

• For more information about BPRP,
visit http://www.ncqa.org/bprp

For more information, including instructions and frequently asked questions, visit NCQA at www.ncqa.org/Recognition
CMS eRX/ePrescribing:How to avoid the penalty in 2012

2011 Electronic Prescribing (eRx) Incentive Program Update

In November, the Centers for Medicare & Medicaid Services announced that, beginning in 2012, eligible professionals who are not successful electronic prescribers 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%>

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

How to Avoid the 2012 eRx Payment Adjustment

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

- Is not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of Jun 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.

For additional information, please visit the “Getting Started” webpage at http://www.cms.gov/erxincentive on the CMS website for more information; or download the Medicare’s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.

Friday, November 19, 2010

ONC Personal Health Records Understanding the Evolving Landscape Webcast

Due to an overwhelming response to the December 3, 2010 PHR Roundtable, pre-registration for in-person attendance has reached its capacity. However, you may still participate in the Roundtable via webcast. To register for the webcast, click here.

Wednesday, November 17, 2010

Nursing’s New Roadmap: Education, the Workforce, and Health Care Quality Webinar

I strongly encourage those interested in Nursing to register for this event. SV

Thursday, November 18, 2010
2:00 PM – 3:00 PM Eastern Time

Click here to register.


Donna Shalala, PhD, former US Secretary of Health and Human Services; President, University of Miami; Chair, Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, Institute of Medicine

Linda Burnes Bolton, DrPH, RN, FAAN, Vice President for Nursing and Chief Nursing Officer, Cedars-Sinai Medical Center; Vice Chair, IOM Committee on the Future of Nursing

Patricia Benner, RN, PhD, FAAN, Senior Scholar, Carnegie Foundation for the Advancement of Teaching; Author, Educating Nurses: A Call for Radical Transformation and From Novice to Expert: Excellence and Power in Nursing.

Learn more about the speakers

What’s it going to take for the health care system to take full advantage of the potential of nurses – and for nurses to realize their full potential? These twin questions are not new to the nursing profession, or to policy makers. Both groups have been wrestling for years to find the right levers to increase not just the ranks of RNs, but their skills and recognition as key members of health care teams. Although this has led to some successes and improvements, the solutions haven’t kept up with demands. Health care reform has only intensified the need to sharpen strategies, especially as nurses have the potential to play a critical role in creating a more patient-centered, integrated delivery system.

In October, the Institute of Medicine released a report called The Future of Nursing: Leading Change, Advancing Health. The study committee’s Chair and Vice Chair, Donna Shalala and Linda Burnes Bolton, will join us on the next WIHI to review the recommendations and to talk about how to turn the substantial report into action. Everyone in health care, not just nurses, has a role to play in driving many of the ideas forward. One of health care’s and nursing’s most respected educators, Patricia Benner, will round out the panel with some special focus on the changes needed in nursing education to ensure that RNs have the necessary skills and preparation to assume greater leadership and patient care roles.

Any discussion about the goals and ambitions for any health profession must take into consideration how these align with the needs of health care reform – including better quality, better health, at reduced costs. Please join the next WIHI to help forge and further the connections to nursing. See you then!

Saturday, November 13, 2010

2009 Electronic Prescribing (eRx) Incentive Program Update


LE will appear on remittance, indicating an incentive payment.

RX09: is the 2009 eRx incentive payments 4-digit code


The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that incentive payments for the 2009 Electronic Prescribing (eRx) Incentive Program were made to eligible professionals who met the criteria for successful reporting.

The 2009 eRx incentive payments are currently being processed and distributed by Carriers and Medicare Administrative Contractors (MACs). Distribution of the 2009 eRx incentive payments were completed by October 22, 2010.

E-prescribing incentives earned by individual participating physicians and other eligible professionals are paid as a lump-sum to the Taxpayer Identification Number (TIN) under which the EP’s claims were submitted. It is then up to the TIN to decide how to distribute the incentive within the practice.

Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remittance advice. Additionally the paper remittance advice will read “This is an eRx incentive payment.” It will not include the year and indicator LE in the paper remittance. In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2009 eRx incentive payments, the 4-digit code is RX09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX09 to identify that payment as the 2009 eRx incentive payment.

2009 Electronic Prescribing (eRx) Incentive Program Feedback Reports

The 2009 eRx feedback reports will be available on the Physician and Other Health Care Professionals Quality Reporting Portal at http://www.qualitynet.org/pqri on the internet, starting the second week of November. TIN-level reports on the Portal require an Individuals Authorized Access to CMS Computer Services (IACS) account. Participants may also contact their Carrier or MAC to request individual NPI-level reports via an alternate feedback report fulfillment process, please visit http://www.cms.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website.

Who to Contact for Questions?

If you have questions about the status of your eRx incentive payment (during the distribution timeframe), please contact your Provider Contact Center. The Contact Center Directory is available at http://www.cms.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip on the CMS website.

Feel free to contact the QualityNet Help Desk with any of the following:

· Physician Quality Reporting Initiative (PQRI) Portal password issues

· PQRI/eRx feedback report availability and access

· PQRI-IACS registration questions

· PQRI-IACS login issues

The QualityNet Help Desk is available Monday through Friday from 7:00 a.m. – 7:00 p.m. CST at 1-866-288-8912 or via qnetsupport@sdps.org on the internet. The QualityNet Help Desk is also available to assist with PQRI and eRx measure-specific questions.

Friday, November 12, 2010

2nd Annual Canada – U.S. eHealth Summit

The Union League, Philadelphia, PA
November 16, 2010

I. Registration / Breakfast / Sponsor Booths 8:00-9:00AM

II. Welcome / Intros 9:00-9:15AM -

- David F.J. Marshall, Canadian Consul in Philadelphia


Forging partnerships between patients, their families and caregivers and physicians and payers to create a continuous, comprehensive care model for all stages of life from pediatrics to geriatrics; acute care; chronic care; preventive services; and end of life, which is secure, accessible, compassionate, and culturally effective. Canadian health officials weigh in with appraisals of their own health system.

Keynote: Dr. Barry Straube, CMO and Director, Office of Standards and Quality, CMS

Keynote: William Pascal, CTO, Canadian Medical Association

- 15 minute BREAK

Keynote: John Glaser, PhD, CEO, Health Services, Siemens Healthcare

Moderator: Phil Magistro/Governor’s Office


a.) Rachel Block/New York State

b.) Henry Fader, Esq./Pepper Hamilton

c.) Mary Madison/AHIMA Foundation

d.) Dr. John Haughton/Covisint-DocSite

- LUNCH / Sponsor Booths – Noon to 1:00PM


How the Greater Philadelphia region can leverage its world class assets in medicine, education, life sciences and pharmaceuticals to become a global leader in health information technology, and how HTX already is a leading resource and catalyst for accelerating the growth of Ontario’s Medical and Assistive Technologies industry cluster.


Keynote: Rob Wonderling, President and CEO, Greater Philadelphia Chamber of Commerce

Keynote: Tony Iantorno, Founder, Accelero Management Consulting and

Joshua Lawson, Associate Partner, SECOR Consulting

Moderator: Elliot Sloane, PhD/Drexel and DVHIMSS


a.) JoAnn Klinedinst/HIMSS and PAeHI

b.) Dr. Thompson Boyd/Hahnemann University Hospital

c.) Dr. John Cacciamani/Temple University Hospital

d.) Dr. Gary Kurtzman/Safeguard Scientifics

- 15 minute BREAK


Information and communications technologies have helped to revolutionize business; can they do the same for health? Presenting examples from Canada and the U.S. on how telemedicine, telehealth and mobile communication devices are being deployed to improve outcomes, lower costs and overcome disparities in healthcare delivery.

Keynote: Dr. Ed Brown, CEO, Ontario Telemedicine Network

Keynote: David Levine, President, Montreal Health and Social Service Agency

Moderator: Dr. Sal Volpe/TLC QIO


a.) Alex Nason/Johns Hopkins Medicine

b.) Brian Wells/University of Pennsylvania Health System

c.) Dr. Joseph Couto/Thomas Jefferson University

d.) Dr. Robyn Tamblyn/McGill University

VI. Reception (5:00 – 6:00pm)

On-line registration: http://www.dvhimss.org/

Directions & parking: http://www.unionleague.org/directions-parking.php

Event Information: markwstevens@verizon.net; Vincent.finn@international.gc.ca

Tuesday, November 09, 2010

HIMSS and CDW Meaningful Use Seminars

November 16th November 30th

San Francisco Phoenix

Grand Café Arizona Biltmore

501 Geary at Taylor Street 2400 East Missouri Ave.

San Francisco, CA 94102 Phoenix, AZ 85016


December 8th December 14th

Chicago Northern NJ

Omni Hotel Il Villagio

676 N Michigan Ave 651 Route 17 North

Chicago, IL 60611 Carlstadt, NJ 07072


HIMSS, the nation's leading caused-based health IT membership organization, in partnership with CDW Healthcare, the leading provider of technology solutions, invite you to a complimentary dinner and presentation…

Understanding the Implications of Meaningful Use

for Ambulatory Practice Eligible Professionals

6:00 pm - 6:45 pm: Check-in and Networking/Cocktail Reception

6:45 pm - 8:30 pm: Dinner presentation with Q&A

RSVP Today

Featured Speakers:

Elise Singer, MD, MBA
Chief Medical Officer

California Health Information and Partnership and Services Organization (CalHIPSO)

November 16th in San Francisco

Kenneth Adler, MD, CPHIMS

Medical Director for Information Technology

Arizona Community Physicians

November 30th in Phoenix

Patricia B. Wise, RN, MS, MA, FHIMSS, COL, USA (ret'd)
Vice President, Healthcare Information Systems

November 16th in San Francisco & November 30th in Phoenix

Fred D. Rachman, MD


Alliance of Chicago Community Health Services

December 8th in Chicago

S. Vincent Grasso, DO

Surgeon Family Practice, North Bergen, NJ

Adjunct Professor, Stevens Institute of Technology

December 14th in Northern New Jersey

Mary P. Griskewicz, MS, FHIMSS
Senior Director, Ambulatory Information Systems

December 7th in Chicago & December 14th in Northern New Jersey

This Meaningful Use Thought Leadership Program is an exclusive event for ambulatory physicians, practice owners and practice administrators.

Meeting incentive requirements is much more than funding...it's also about revenue growth and avoiding government penalties. Two industry leaders have joined forces to help you understand the full implications of meaningful use.

Your RSVP is requested...

The consequences for not achieving meaningful use can be translated into lost funding in the shorter term and revenue loss and regulatory penalties in the longer term. For more information and to RSVP, please contact Stephanie Serra at sserra@himss.org or (312) 915-9222. Seating is limited, so act now.

Don't miss this strategic and solution-centric opportunity for meeting incentive requirements. It's that important!

Sunday, October 31, 2010

Preparing the Small Practice for Meaningful Use: AMA Webinar

Planning to qualify for EHR incentives? Or, just wondering how to select, implement and use EHR technology without running your practice into the ground? The AMA’s 60-minute live webinar taking place on November 4 will arm you with best practices and strategies--used in real practices--to help guide Health IT decisions in your practice.

Join the American Medical Association (AMA) for its first in a two-part series of webinars designed to help small practices make sound Health IT decisions.

Learn more about:

* Preparing for Health IT
* Selecting Health IT
* Implementing Health IT, and
* Choosing which meaningful use criteria apply to your practice

Register Here

Friday, October 29, 2010

TransforMED and RelayHealth Align to Provide Patient-Centered Health Care Connectivity Solutions










Featured Speakers:

Rosemarie Nelson, MS

Principal, MGMA Healthcare Consulting Group

Hal Baker, M.D.

Chief Information Officer, Wellspan Health

Followed by a Q&A Discussion including

Jeffrey Krupen, M.D.

Randy Kiewe, M.D.

Wednesday, November 17th, 6:30 P.M.

Rust Auditorium

North Shore University Hospital

Wednesday, October 27, 2010

The New York State Health Information Technology Operational Plan

On October 26, the New York State Health Information Technology Operational Plan was submitted to the Office of the National Coordinator (ONC).

Click here to read the press release on the topic.

Click here to see the interview with David Whitlinger, Executive Director of NYeC.


Sunday, October 17, 2010

Hospital Meaningful Use Tips

Want to earn Medicare Electronic Health Record (EHR) incentive payments?

Take the First step!!

Your hospital/critical access hospital must have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS) in order to be eligible to receive a Medicare EHR incentive payment.

Did you know?

Billing and receiving payments from Medicare does not necessarily mean that a hospital or a critical access hospital has an enrollment record in PECOS.

Don’t wait!

1. Act now to verify that your facility has an enrollment record in PECOS.

2. If your facility does not have a record in PECOS, establish an enrollment record now.

If you have submitted a Medicare enrollment application within the last 90 days, and your enrollment application has been accepted for processing by the fiscal intermediary or A/B MAC, you need not take any additional actions based on this listserv message. (You will be contacted by your fiscal intermediary or A/B MAC if additional information is needed.)

How can I find out if my facility has an enrollment record in PECOS? Choose one of the following:

1. Use Internet-based PECOS to look for your PECOS enrollment record. If no record is displayed, you do not have an enrollment record in PECOS. (If you do not currently have access to Internet-based PECOS, see Basics of Internet-based PECOS for Provider and Supplier Organizations for instructions.)

2. Contact your designated Medicare enrollment contractor and ask if you have an enrollment record in PECOS. Go to Contractor List for contact information.

My facility doesn’t have an enrollment record. What should I do?

Internet-based PECOS is the fastest and most efficient way to submit your enrollment application. For instructions, see Basics of Internet-based PECOS for Provider and Supplier Organizations . If you encounter problems or have questions as you navigate the system, there is help available .

Electronic Health Record Incentives – Get the Facts from CMS www.cms.gov/EHRincentiveprograms

Saturday, October 09, 2010

The New York State Health Information Technology Operational Plan:
Roadmap for the Future of Healthcare Technology in New York Webinar

Join Rachel Block, Deputy Commissioner for Health Information Technology Transformation at the New York State Department of Health (DOH), and David Whitlinger, Executive Director of the New York eHealth Collaborative (NYeC) to review the New York State Health Information Technology Operational Plan.

The Operational Plan was developed by NYeC in collaboration with the DOH and healthcare stakeholders from around the state. It details New York’s overall approach to Health IT for the coming years and specifies how the state will achieve technology-enabled healthcare transformation statewide, utilizing over $100M in state and federal funding.

Join Rachel and Dave at one of these webinars to learn more about the plan and to share your feedback.

Please select from the following webinars. We would also appreciate your help in forwarding this invitation to other colleagues who may find value in participating.

Tuesday Oct. 12 @ 1pm
Wednesday Oct. 13 @ 11am
Thursday Oct. 14 @ 10am

Please note: Audio portion is via telephone, not through your computer.

Login Instructions

Step 1: Call In: 1-800-926-5230

Step 2: Log in: Click on or copy the following url into your browser: http://www.readytalk.com/?ac=6196403

IMPORTANT: If you have not used ReadyTalk before, please go to: http://test.readytalk.com to test the computer you'll be using for compatibility prior to the event.

Should you have any problems please contact ReadyTalk Support at 1-800-843-9166

2009 Electronic Prescribing (eRx) Incentive Program Update, Feedback Reports

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce important information about accessing 2009 Electronic Prescribing (eRx) Incentive Program feedback reports is posted to the eRx webpage at http://www.cms.gov/ERXincentive on the CMS website.

The 2009 eRx Incentive Program feedback reports will be available in November 2010 after the 2009 eRx incentive payments are distributed. Feedback reports are compiled at the Taxpayer Identification Number (Tax ID Number, or TIN) level, with individual-level reporting (by National Provider Identifier or NPI level) information for each Eligible Professional (EP) who reported at least one valid eRx quality-data code (QDC) on a claim submitted under that TIN for services furnished during the reporting period.

Several new and updated educational resource documents about accessing 2009 Electronic Prescribing (eRx) Incentive Program feedback reports are now available on the “Spotlight, 2009 PQRI Program and eRx Overview” links of the eRx website and include the following:

  • A downloadable WORD document on accessing 2009 eRx Incentive Program Feedback Reports.
  • 2009 PQRI Feedback Report User Guide
  • 2009 eRx Feedback Report User Guide
  • A Guide for Understanding 2009 PQRI Incentive Payment

2010 Electronic Prescribing (eRx) Incentive Program Participation Reminder

It’s not too late to start participating in the 2010 Electronic Prescribing (eRx) Incentive Program and potentially qualify to receive a full-year incentive payment. Eligible professionals (EPs) may begin reporting eRx at any time throughout the 2010 program year of January 1-December 31, 2010 to be incentive-eligible.

The Electronic Prescribing Incentive Program is a separate incentive program from the Physician Quality Reporting Initiative (PQRI), with different reporting requirements. To successfully meet reporting criteria and be considered incentive eligible, individual EPs must report the eRx measure at least 25 times (for eligible patient encounters) and the Medicare Part B Physician Fee Schedule (PFS) allowed charges for services in the eRx measure’s denominator should be comprised of 10% or more of the EP’s total 2010 estimated allowed charges.

For 2010, eligible professionals who successfully report the eRx measure will become eligible to receive an eRx incentive equal to 2.0% of their total Medicare Part B Physician Fee Schedule (PFS) allowed charges for services performed during the reporting period. Eligible professionals must have adopted a “qualified” eRx system. There are two types of systems: a system for eRx only (stand-alone) or an electronic health record (EHR system) with eRx functionality. Regardless of the type of system used, to be considered “qualified” it must be based on ALL of the following capabilities:

§ Generating a complete active medication list incorporating electronic data received from applicable pharmacies and pharmacy benefit managers (PBMs) if available

§ Selecting medications, printing prescriptions, electronically transmitting prescriptions, and conducting all alerts

§ Providing information related to lower cost, therapeutically appropriate alternatives (if any). (The availability of an eRx system to receive tiered formulary information, if available, would meet this requirement for 2010)

§ Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan, if available.

If you have not yet participated in the eRx program, you can begin by reporting eRx data for January 1-December 31, 2010 using any of the following three options:

§ Claims-based reporting of the eRx measure. Report only one G-code (G8553) for 2010

§ Registry-based reporting using a CMS-selected *registry, submitting 2010 data to CMS during the first quarter of 2011

§ EHR-based reporting using a CMS-selected *electronic health record product, submitting 2010 data to CMS during the first quarter of 2011

*Only registries and EHR vendors who have been selected by CMS for the 2010 PQRI/eRx and are on the posted list of registries/EHR vendors are eligible to be considered “qualified” for purposes of the 2010 Electronic Prescribing Incentive Program (visit http://www.cms.gov/ERxIncentive/08_AlternativeReportingMechanism.asp on the CMS website).

Claims-based reporting involves the addition of a quality-data code (QDC) to claims submitted for services (occurring during the reporting period) when billing Medicare Part B. EPs also have the option of using a qualified registry to assist in collecting eRx measure data. The registry will submit this quality data directly to Medicare, eliminating the need for adding the QDC to the Medicare Part B claim.

Eligible professionals do not need to sign up or pre-register to participate in the 2010 eRx. Reporting one QDC (G8553) for the eRx measure to CMS through claims, or submission via a qualified registry or a qualified EHR will indicate intent to participate.

Although there is no requirement to register prior to submitting the data, EPs should review the educational products CMS has created on how to get started with eRx reporting. To access all available educational resources on eRx please visit http://www.cms.gov/eRxIncentive/on the CMS website. Eligible professionals are encouraged to check the eRx webpage often for the latest information and downloads.

Additional Resources:

§ 2010 eRx Measure Specification and Release Notes (EPs should the eRx measure specification documents for the current program year. Refer to the specification for the reporting method applicable to your practice):

o Claims- and registry-based at http://www.cms.gov/ERxIncentive/Downloads/2010_eRx_MeasureSpecificationsandReleaseNotes_121709.zip

o EHR-based at http://www.cms.gov/ERxIncentive/Downloads/2010EHRMeasureSpecificationforeRxandReleaseNotes.zip

§ Claims-Based Reporting Principles for Electronic Prescribing (eRx) Incentive Program at http://www.cms.gov/ERxIncentive/Downloads/Claims-BasedReportingPrinciplesforeRx122209.pdf

§ 2010 eRx Incentive Program Made Simple Fact Sheet at http://www.cms.gov/ERxIncentive/Downloads/2010eRxMadeSimpleFS032310f.pdf

§ 2010 eRx Incentive Program Fact Sheet: What's New for 2010 eRx Incentive Program at http://www.cms.gov/ERxIncentive/Downloads/WhatsNew2010eRxFS032310f.pdf

Questions? If you have questions on how to get started with eRx, please contact the QualityNet Help Desk at 866-288-8912 (from 7am-7pm CST) or via e-mail at qnetsupport@sdps.org.