The Government Accountability Office (GAO) recommended on February 17 that variances in requirements be ironed out for two key programs . The GAO directed this urgent request at the Centers for Medicare & Medicaid Services in reference to the Meaningful Use incentive program and the penalties that will soon be applied under the electronic prescribing program.
The GAO identified inconsistencies between the Electronic Prescribing Program (eRx) and the EHR program established under the HITECH act. Medicare providers who use qualified E-Prescribing systems that meet the CMS definition are entitled to receive incentive payments. Penalties may also be applied from 2012 to 2014 for eligible porviders who do not adopt and use E-Prescribing systems.
The “Meaningful Use” incentive program provides qualified physicians with incentive payments between 2011 and 2016 if they adopt and meaninfully use ONC-ATCB certified EHR that includes E-Prescribing functionality as part of the Meaningful Use program. If eligible providers do not adopt and meaningfully use a certified EHR by 2015, they could face penalties.
The GAO believes that the inconsistencies may create further confusion and limit effectiveness of both programs unless resolved. For example, reporting requirements for the EHR incentive program are more comprehensive than for the eRx program. There are also differences in the annual limits for incentives that can be paid to eligible providers under each program. Under the eRx program, an eligible provider can receive up to $67,500 annually vs. a maximum of $18,000 annually under the EHR program.
What GAO Recommends
GAO is recommending that the CMS Administrator take four actions, including (1) encourage physicians and other providers in the Electronic Prescribing Program to adopt certified technology and (2) expedite efforts to remove the overlap in reporting requirements for physicians who may be eligible for incentive payments or subject to penalties under both programs. CMS generally agreed with three recommendations and disagreed with a fourth recommendation, which GAO clarified based on CMS’s comments.
The report is available for download here (.pdf)
This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.