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 ...

healthcare.philips.com
from healthcare.philips.com More from this publisher
19.02.2013 Views

CMS-1403-FC of 2010 and will be performed by dividing the individual’s total 2009 charges submitted for the measure’s HCPCS codes by the individual’s total Medicare Part B charges (as assessed at the NPI/TIN level). If the result is 10 percent or more, then the statutory limitation does not apply and a successful electronic prescriber would earn the electronic prescribing incentive payment. If the result were less than 10 percent, then the statutory limitation would apply and the eligible professional could not receive an electronic prescribing incentive payment. As discussed previously, this limitation will be applied by CMS in determining whether the individual professional meets the requirements for the incentive payment. Although individual eligible professionals may decide about whether to report based on their own assessment of what portion of their allowed charges for Part B services are likely to be made up of services represented by the denominator codes, individual professionals may report the numerator codes without regard to the statutory limitation for the incentive payment. If an eligible professional meets the 10 percent threshold for 2009, we will determine whether the professional is a successful electronic prescriber by reporting the numerator codes for 50 percent of applicable 698

CMS-1403-FC cases. If the is determined to be a successful electronic prescriber, then the incentive payment will be made. As indicated above, for 2009, the electronic prescribing incentive payment is 2.0 percent of the total estimated Part B allowed charges for the reporting period (that is, the entire year, for 2009). Thus, the incentive payment is not solely 2.0 percent of the estimated Part B allowed charges for services for which the measure is reported, but 2.0 percent of all estimated Part B allowed charges for the year. In other words, although the measure denominator is limited to certain office and outpatient professional services, and the requirement to be an electronic prescriber is based on those services, the incentive payment is paid as 2.0 percent of all estimated Part B allowed charges for the professional, submitted by the end of February, 2010. g. Uses of Information on Successful Electronic Prescribers As discussed in section II.O1.e.i. above, section 1848(m)(5)(G) of the Act, as added by the MIPPA and described in section III. of this final rule with comment period, requires the Secretary to post on the CMS Web site, in an easily understandable format, a list of the names of eligible professionals (or group practices) who 699

<strong>CMS</strong>-1403-FC<br />

cases. If the is determined to be a successful electronic<br />

prescriber, then the incentive payment will be made.<br />

As indicated above, for 2009, the electronic<br />

prescribing incentive payment is 2.0 percent of the total<br />

estimated Part B allowed charges for the reporting period<br />

(that is, the entire year, for 2009). Thus, the incentive<br />

payment is not solely 2.0 percent of the estimated Part B<br />

allowed charges for services for which the measure is<br />

reported, but 2.0 percent of all estimated Part B allowed<br />

charges for the year. In other words, although the measure<br />

denominator is limited to certain office and outpatient<br />

professional services, and the requirement to be an<br />

electronic prescriber is based on those services, the<br />

incentive payment is paid as 2.0 percent of all estimated<br />

Part B allowed charges for the professional, <strong>submitted</strong> by<br />

the end of February, 2010.<br />

g. Uses of Information on Successful Electronic<br />

Prescribers<br />

As discussed in section II.O1.e.i. above, section<br />

1848(m)(5)(G) of the Act, as added by the MIPPA and<br />

described in section III. of this final rule with comment<br />

period, requires the Secretary to post on the <strong>CMS</strong> Web site,<br />

in an easily understandable format, a list of the names of<br />

eligible professionals (or group practices) who<br />

699

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!