Medicare Incentives

Did You Know? Starting now, physicians who prescribe for Medicare patients are eligible for Medicare Incentives of a .5% increase on their Medicare reimbursement payment.

Medicare Incentives
In July 2008, the federal government implemented the Medicare Improvements for Patients and Providers Act (MIPPA) as an initial step towards mandating e-prescribing technology by using a “carrot and stick” approach. Early adopters are eligible for Medicare Incentives, and providers who delay utilization of e-prescribing technology will be penalized for non-compliance.

How much money can I expect to receive regarding Medicare Incentives?

This amount varies depending on all Medicare Part-B billings, but is estimated between $1,500 - $2,000 per provider.

How do I earn my Medicare Incentives?

The simple answer is that you need to begin writing and transmitting your prescriptions using a qualified an electronic prescription system like Rcopia from DrFirst. To receive the full benefits of e-prescribing and ensure smooth workflow in the office, we recommend that you utilize your e-prescribing system to write prescriptions for all patients, not just Medicare patients. The Centers for Medicare and Medicaid (CMS) will measure your electronic medication prescribing activity on an annual basis, and will award you the Medicare Incentives if you meet the required levels of participation. In order meet the minimum requirements to capture the Medicare Incentives, you should being e-prescribing immediately. A provider must report the ePrescribing G-code, G8553, at least 25 times for Medicare office visits. When reporting the G-code, the practice must list a charge of $0.01 in order for this to be recognized by CMS.

How do I verify that my e-prescribing system meets all the requirements?

The quickest and easiest way to determine whether your e-prescribing system is qualified and meets the PQRI and MIPPA requirements, is to select a Surescripts Gold Certified vendor.

As a qualified system, Rcopia fulfills the following requirements**:

  • Generate a medication list
  • Select medications, transmit prescriptions electronically and conduct safety checks
  • Safety checks include: automated prompts that offer information on the drug being prescribed, potential inappropriate dose or route of administration of the drug, drug-drug interactions, allergy concerns, and warnings/cautions.
  • Provide information on lower cost alternatives
  • Provide information on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan If your chosen system is not GoldRx certified, we recommend that you speak with your vendor and ask for a demonstration of each required capability in order to ensure compliance.
It’s not too late! Adopt prescription management software soon and be sure that you meet Medicare Incentives requirements to collect the maximum payment - which can earn each doctor in your practice, on average, an extra $1,000 to $2,000 (or more depending on the volume of Medicare patients) per year. The longer you wait, the less likely you will get the maximum amount of Medicare Incentives!