decisionhealth Newsletters, Coder Pink Sheets - 2008 Issue 10 (October)
E-prescribing to get its own 2% incentive bonus next year
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Article Overview
This article covers a Medicare reporting update affecting e-prescribing and its relationship to the PQRI program. It is aimed at practices and clinicians who track Medicare quality incentives and need a general understanding of the reporting shift, participation timeline, and system requirements discussed by CMS.
Why This Topic Matters
The article is relevant to practices that want to understand how Medicare quality reporting changes may affect incentive payments and future penalties. It also helps readers identify the broad operational and compliance issues surrounding adoption of an e-prescribing system.
Article Sections
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Medicare incentive changes for e-prescribing
Overview of the coming separation of e-prescribing from PQRI and the related Medicare participation incentives discussed by CMS.
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Reporting expectations and denominator scope
Discussion of the reporting frequency change, participation thresholds, and the types of office visit services included in the measure scope.
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Required reporting codes
Presentation of the reporting codes associated with the measure and the setting in which they are used.
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Future payment adjustments
Summary of the later incentive phase-down and the scheduled Medicare payment penalties tied to nonparticipation.
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CMS system requirements for e-prescribing
General functional capabilities CMS says an electronic prescribing system should support in order to qualify for the measure.
What You Will Learn
- How the article frames the relationship between e-prescribing and Medicare quality reporting
- What broad reporting changes are described for the upcoming program year
- What categories of codes are referenced in connection with the measure
- What kinds of system functions CMS expects from a qualifying e-prescribing system
- How the article presents the longer-term incentive and penalty timeline
Who Should Read This
- Physicians and physician practices
- Medical coders and billing staff
- Practice managers
- Health information and compliance staff
- Clinicians participating in Medicare quality programs
Codes Discussed
Code Ranges Discussed
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