Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC for the years 2009 through 2013, and payment differentials apply starting 2012 and for all subsequent years. Specifically, for 2009, in accordance with section 1848(m)(2) of the Act, as added by section 132(a) of the MIPPA, a “successful electronic prescriber” as defined by MIPPA and further discussed below, is eligible to receive an incentive payment equal to 2.0 percent of the total estimated allowed charges submitted not later than 2 months after the end of the reporting period for all covered professional services furnished during the 2009 reporting period. This new E-prescribing Incentive Program is separate from and in addition to any incentive payment that eligible professionals may earn through the PQRI program discussed above. Incentive payments for successful electronic prescribers for future years are authorized as follows: ● 2.0 percent for 2010. ● 1.0 percent for 2011. ● 1.0 percent for 2012. ● 0.5 percent for 2013. Under section 1848(a)(5) of the Act, as added by section 132(b) of the MIPPA, a PFS payment differential applies beginning in 2012 to those who are not successful electronic prescribers. Specifically, for 2012 and any 676
CMS-1403-FC subsequent year, if the eligible professional is not a successful electronic prescriber for the reporting period for the year, the fee schedule amount for covered professional services furnished by such professionals during the year shall be less than the fee schedule that would otherwise apply by: ● 1.0 percent for 2012. ● 1.5 percent for 2013. ● 2.0 percent for 2014 and each subsequent years. The application of the payment differential will be the subject of future notice and comment rulemaking and is beyond the scope of this rule. Under section 1848(m)(6) of the Act, as amended by the MIPPA, the definition of “eligible professional” for purposes of eligibility for the electronic-prescribing incentive program is identical to the definition of “eligible professional” for the 2009 PQRI under section 1848(k)(3)(B) of the Act. In other words, eligible professionals include physicians, other practitioners as described in section 1842(b)(18)(C) of the Act, physical and occupational therapists, qualified speech-language pathologists, and beginning in 2009, qualified audiologists. However, eligibility is further restricted 677
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<strong>CMS</strong>-1403-FC<br />
subsequent year, if the eligible professional is not a<br />
successful electronic prescriber for the reporting period<br />
for the year, the fee schedule amount for covered<br />
professional services furnished by such professionals<br />
during the year shall be less than the fee schedule that<br />
would otherwise apply by:<br />
● 1.0 percent for 2012.<br />
● 1.5 percent for 2013.<br />
● 2.0 percent for 2014 and each subsequent years.<br />
The application of the payment differential will be the<br />
subject of future notice and comment rulemaking and is<br />
beyond the scope of this rule.<br />
Under section 1848(m)(6) of the Act, as amended by the<br />
MIPPA, the definition of “eligible professional” for<br />
purposes of eligibility for the electronic-prescribing<br />
incentive program is identical to the definition of<br />
“eligible professional” for the 2009 PQRI under section<br />
1848(k)(3)(B) of the Act. In other words, eligible<br />
professionals include physicians, other practitioners as<br />
described in section 1842(b)(18)(C) of the Act, physical<br />
and occupational therapists, qualified speech-language<br />
pathologists, and beginning in 2009, qualified<br />
audiologists. However, eligibility is further restricted<br />
677