Avoid Medicare Part B Penalties for PQRS, e-prescribing and Meaningful Use
If you are a Medicare Part B provider, now is the time to pay close attention to the quality programs administered by the Centers for Medicare and Medicaid Services (CMS) in order to avoid penalties (claim adjustments) in the near future. Beginning this year, Medicare providers must report information to CMS in order to avoid penalties from three different programs: PQRS, eRx, and Meaningful Use.
You are probably familiar with these programs in the incentive context, but we’ve now reached a point where you must participate in order to avoid payment adjustments to your Medicare reimbursements in the coming years. Below is a snapshot of the potential payment adjustments that you face if you don’t participate in the 2013 reporting year.
Physician Quality Reporting System (PQRS)
PQRS is a reporting program established by federal legislation to measure the quality of care provided to Medicare patients with certain conditions. Since there are a very large number of PQRS measures, physicians and practitioners of all specialties should be able to find measures that relate to their patient population. You have a few options for meeting PQRS requirements in order to avoid the penalty.
eRx (e-Prescribing) Incentive Program
Similar to PQRS, the eRx incentive program is another reporting program established by federal legislation to improve the efficiency and accuracy of dispensing medications to patients.
To avoid a 2014 penalty, you can do one of the following this year:
- Demonstrate Meaningful Use before June 30, 2013 (if you attested in 2012, you will also be excluded)
- Report quality data codes (G8553) on claims for 10 Medicare Part B visits by June 30, 2013. G8553 indicates that a prescription was sent electronically for the corresponding patient visit
- Qualify for one of the additional exclusion criteria
Meaningful Use- EHR Incentive Program
Meaningful Use aims to improve the quality of care for all patients by leveraging the benefits of accurate data capturing and sharing by using Electronic Health Records.
Medicare providers who attested in 2011 or 2012 must continue to do so in 2013 to avoid the first year penalty. If you haven’t demonstrated Meaningful Use yet, you can get started this year to earn up to $39,000 in Medicare incentives. In order to make the transition easier for your practice, Practice Fusion has developed a variety of resources to help your practice easily get started with Meaningful Use and stay on track to earning incentives.
To learn more about eligibility and program requirements, visit Practice Fusion’s Meaningful Use Center:
Join a Live Webinar with CMS
CMS is hosting a series of webinars during the next two weeks. You can learn more about avoiding penalties for all programs described above.