December 24, 2009


2010 MIPPA: Will You Be Motivated by the Carrot or the Stick?


We’ve all heard the mantra: e-prescribing can make a difference in your day-to-day workload, helping you save time, gain practice efficiency, and increase patient safety. So if the benefits are so obvious, why isn’t every physician hopping on the e-prescribing bandwagon?

Now, the Federal and local government authorities have created several incentive/penalty (carrot or stick) approaches to drive e-prescribing adoption – most notably the Medicare Improvements for Patients and Provider Act (MIPPA). CMS has revised MIPPA for 2010 to not only further sweeten the pot and entice new users with greater ease of reporting and eligibility, but to also streamline current users’ experience.

Finalized changes to be implemented on January 1, 2010 include:

2009: There were three G-codes related to different e-prescribing scenarios.
2010: There is only one G-code (G8553) to show a visit resulted in an e-prescription.

2009: Providers were required to enter respective G-codes for e-prescribing events in 50% of eligible ambulatory visits.
2010: Providers are only required to enter the new G-code 25 times during the calendar year.

2009: The reporting process needed to be conducted through the current claims-based reporting mechanism.
2010: In addition to claims-based reporting, any Registry or EHR which has qualified for 2010 PQRI may be used for reporting.

2009: There were strict limitations on which providers are eligible.
2010: The incentives are now extended to professional services furnished in skilled nursing facilities, domiciliary care, and the home care setting.

Current E-Prescribers – Stay Informed

These changes aid providers who qualified in 2009 by bringing the carrot even closer for 2010 and clearing the obstacle course. Moving forward, providers need to be sure to enter the new G-code. Entering last year’s g-codes will result in the loss of eligibility for the incentives.

Still Thinking About E-Prescribing? – Don’t Miss Out On The Whole Carrot!

2009 is over! 2010 is the last year to receive the full 2% reimbursement. After 2010, the incentives dwindle the penalties begin (and increase)! Follow these 3 easy steps to capture your full 2% bonus before CMS dangles a smaller carrot, and eventually takes it away (the incentive decreases to 1.5% in 2011) or starts swatting you with that stick…:

  1. Purchase a qualified e-prescribing system
  2. Add G8553 to your Superbill
  3. Bill G8553 with at least 25 E&M visits to indicate you sent at least one electronic prescription associated with each of those visits

Leave us a comment about your experience with MIPPA reporting thus far, and share your thoughts about whether you think the new revisions will help or hinder you and your practice.

About pkaufman

Schooled at MIT, Dr. Kaufman nurtured a strong interest in medical informatics while a Bowman Gray School of Medicine faculty member. After entering private practice he founded PiNK software in 1996 to produce EMR software, later becoming DrFirst’s chief medical officer upon its founding. He lectures nationally on various healthcare IT topics, and as a board certified gastroenterologist, he continues a limited clinical practice. Dr. Kaufman is a member of the Health IT Standards Committee, Privacy and Security Workgroup for ONC (Office of the National Coordinator for Healthcare Information Technology). Representing the American Gastroenterology Association’s (AGA), Dr. Kaufman is a delegate to the AMA and was the co-chair of the Physicians Electronic Health Record Consortium (PEHRC). He has participated on workgroups at CCHIT (stand-alone e-prescribing), HIMSS (e-prescribing), and NCPDP (e-prescribing).