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January 2011
Clinical Practice Management
PQRS and E-Prescribing Resources for ID Physicians
Includes details on how to qualify for Medicare incentive payments and avoid penalties

Updated information to help ID physicians and their practices qualify for Medicare incentive payments for reporting quality measures and for electronic prescribing (eRx) is now available on IDSA’s website. These incentives will be replaced by penalties, as the Centers for Medicare and Medicaid Services (CMS) moves to pay physicians differentially based on the quality and cost of their care.

Physicians must start participating in the eRx program this year to qualify for a 1 percent incentive payment. At least 25 electronic prescriptions during 2011 are required to qualify for the incentive. Providers who do not submit at least 10 electronic prescriptions on their Medicare claims during the first six months of 2011 (by June 30) will see their payments cut by 1 percent beginning in 2012.

IDSA’s “Quality Improvement Resources and Tools” webpage has additional details, including:

  • eRx reporting options and measure specifications
  • available hardship exemptions from eRx requirements and how to request them
  • a link to download free eRx software, which may be a good interim option for practices that need a short-term solution to avoid payment penalties and provide time to implement an EHR system with eRx capabilities
  • an explanation of how the eRx program relates to Medicare’s requirements for meaningful use of EHRs

Under the Physician Quality Reporting System (PQRS), physicians may increase their total Medicare payments in 2011 by 1.0 percent by successfully reporting on applicable quality measures. These incentive payments will drop to 0.5 percent from 2012 to 2014. Starting in 2015, eligible physicians who do not report will see a 1.5 percent penalty. IDSA encourages members to begin reporting through PQRS before payment penalties begin.

Visit IDSA’s website for more information about PQRS, such as:

  • details on PQRS reporting options
  • how to fill out Medicare claim forms to ensure accurate reporting
  • lists of qualified registries and electronic health record (EHR) vendors for PQRS reporting
  • quality measures reportable by ID specialists
  • examples of how the reporting options and quality measures may apply to different service mixes and patient populations
  • where to go for more assistance, including a PQRS telephone and e-mail help line

The “Physician Compare” website developed by Medicare and available to the public currently shows whether a particular physician reported on PQRS measures. Later in 2011, the site will include eRx reporting information, and in future years, additional quality/cost indicators for physicians. It is critical that physicians verify the accuracy of demographic information from Medicare’s Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) as this information is included on the Physician Compare website.

Check IDSA’s website for updates on these and other quality reporting tools and requirements. Members may also contact Jason Scull of IDSA staff with additional questions.
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