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According to The Washington Post, the eHealth Initiative estimates that only about 2 percent of prescriptions written in the United States are transmitted electronically. However, Medicare's E-Prescribing Incentive Program may motivate more physicians to convert from paper-based prescriptions to e-prescribing.

The Medicare e-prescribing incentive is a new program authorized under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). MIPPA authorizes incentive payments for eligible professionals who are successful e prescribers.

Currently, the e-prescribing incentive program is based on one quality measure that is incorporated in the Physician Quality Reporting Initiative (PQRI). The PQRI is a reporting program that provides an incentive payment to eligible professionals who report data on a selected set of quality measures for covered professional services furnished during the appropriate reporting period.

The e-prescribing quality measure will be removed from the PQRI and will become the quality measure for the E-Prescribing Incentive Program starting 2009. Moreover, this means by next year a physician or any other eligible professional could possibly receive two incentive payments: one under the E-Prescribing Incentive Program and the other from PQRI. However, specifications for the 2009 e-prescribing incentive measures are somewhat different from the 2008 PQRI program.

Eligibility will be further restricted by scope of practice to professionals who will have prescribing authority in 2009. An eligible professional must report the e-prescribing quality measure on at least 50 percent of applicable cases during the reporting year in order to be counted as a successful e prescriber. E-prescribing incentive amounts will be 2% of the total estimated allowed charges for professional services covered by Medicare Part B and furnished by an eligible professional during the reporting period (one year). To go in more detail, the incentive payments will be set at 2 percent for 2009 and 2010, 1 percent for 2011 and 2012, and 0.5 percent for 2013.

A penalty will arise in 2012 for not successfully satisfying e-prescribing requirements (eligible professionals who are not "successful e prescribers"). The penalty will result in a percentage reduction in Medicare physician fee schedule payments equal to 1 percent for 2012, 1.5 percent for 2013, and 2 percent for 2014 and subsequent years.

An eligible professional does not have to enroll to participate in the E-Prescribing Incentive Program. Furthermore, an eligible professional does not need to participate in PQRI to participate in this incentive program.

Starting January 1, 2009, eligible professionals may participate in the E-Prescribing Incentive Program by submitting information required by the e-prescribing measure on their Medicare Part B claims.

Additional information on the implementation of the E-Prescribing Incentive Program for 2009 can be found in the final 2009 Medicare Physician Fee Schedule Final Rule.