What You Can Do to Prepare for Medicare Payment Reductions – Medicare Incentives Strategy #1: e-Prescribing

Kathy McCoy, MBA August 23rd, 2011

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Betsy Nicoletti explains how to prepare for medicare pay cuts in this complimentary recorded webinar

By now, most practitioners know that cuts in Medicare payment rates are a very real possibility. As noted in the most recent issue of Amednews, “Few observers of Congress think a new bipartisan panel will achieve its goal of approving a federal deficit reduction plan of at least $1.2 trillion during the next decade and preventing automatic cuts to Medicare, defense and other areas.”

How can physicians and the medical billing professionals who work for them ensure they survive—and even thrive—when the reimbursement outlook is so grim? Kareo recently offered a webinar that tackled that very question—with some promising strategies you can implement in your practice.

During What You Can Do to Prepare for Medicare Payment Reductions, noted practice management consultant and author Betsy Nicoletti, M.S., CPC, offered three overarching strategies that can bring more money back into your practice. Kareo often sponsors webinars that feature industry leaders in practice management and effective medical billing. In a series of blogs, we will touch on the strategies Betsy discussed during her recent webinar.

What was Betsy’s first strategy? Consider taking advantage of Medicare incentive programs. The Affordable Care Act and stimulus program passed by Congress created CMS incentive programs that provide dollars for implementing new ways of managing patient care within a practice. The good news is that there are three main initiatives for which practitioners can earn dollars: e-prescribing, EHR implementation, and the Physician Quality Reporting System (PQRS).  The bad news is that penalties will eventually be levied on payments to those practices that have not adopted these initiatives at certain benchmarks in time.  In the case of e-prescribing, those penalties may kick in as soon as 2012. This blog post will focus solely on the first incentive program, e-prescribing. Upcoming blogs will cover EHR implementation and PQRS separately. Check back, too, for subsequent blogs that will cover Betsy’s second and third main strategies. Don’t want to wait? You can watch the complimentary webinar in its entirety right now.

What e-Prescribing means for You

Practices that are prescribing and transmitting medication orders electronically in 2011 will receive a 1% dividend on payments for those claims that reflect electronic prescriptions. The same incentive—a 1% dividend—will apply through 2012, and then it drops to .5% in 2013.

E-prescribing activity in 2011 also determines if a penalty will be levied in 2012 and beyond.

If a practice cannot show that it has e-prescribed medications in 10 claims during the first half of 2011, a penalty of 1% will be applied to claims submitted in 2012. Similarly, if a practice cannot show it has e-prescribed in 25 Medicare claims submissions throughout calendar year 2011, a penalty will be applied for claims submitted in 2013. Practices that have not started e-prescribing medications by January 1, 2012, will have a 1% penalty levied on claims that do not reflect ordering prescriptions electronically. That penalty increases to 1.5% in 2013 and jumps to 2% in 2014, where it will remain if practices are not e-prescribing by then.  

Of course, there are existing and proposed exemptions to these e-prescribing requirements.  Watch the news and check your medical society website to see if there are revisions to these guidelines. You can also log on to http://www.cms.gov/EPrescribing/ to learn more on how this may affect you.  And don’t forget to check back to read our blogs covering the rest of Betsy’s webinar.

If you would like to be added to our notification list for upcoming informative webinars such as this one, click here.

1 Comment »

    Insurancewhisper said:

    Really appreciate you sharing this post.Much thanks again. Awesome.

    Saturday, July 4, 2015 - 6:11 pm

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