Background

10 - Background (Rev. 10, Issued: 07-27-12, Effective: 10-29-12, Implementation: 10-29-12) Chapter 2 of this manual focuses on the requirements for the Electronic Prescribing (eRx) Incentive Program, a quality reporting program which promotes the adoption and use of eRx systems through a combination of incentives and payment adjustments. ERx is the transmission of prescription or prescription-related information through electronic media. ERx takes place between a prescriber, dispenser, pharmacy benefit manager, or health plan. It can take place directly or through an intermediary (such as a network). Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required the Secretary to establish a new reporting program for individual eligible professionals who are successful electronic prescribers as defined by MIPPA, beginning on January 1, 2009. While the eRx Incentive Program has similarities in structure and processes to the Physician Quality Reporting System (formerly the Physician Quality Reporting Initiative or PQRI) described in Chapter 1 of this Publication, this program is a stand alone program with distinct reporting requirements and associated incentive payment and payment adjustment. The eRx Incentive Program encourages significant expansion of the use of eRx by authorizing a combination of financial incentives and payment differentials. Any incentive payment earned through the eRx Incentive Program is separate from and in addition to any incentive payment that eligible professionals may earn through the Physician Quality Reporting System program. Except for eligible professionals who wish to participate in the eRx Incentive Program under the group practice reporting option (GPRO) beginning 2010 (see §20.2), eligible professionals do not have to participate in Physician Quality Reporting System to participate in the eRx Incentive Program or vice-versa. See Chapter 1, “Physician Quality Reporting System,” for information on the Physician Quality Reporting System.