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Home / News & IndustryManaged Care Insight and Analysis
Updated: March 29, 2011
GAO Cites Medicare For Redundancy In E-Prescribing And HIT Programs

The Government Accountability Office (GAO) is urging the Centers for Medicare and Medicaid Services (CMS) to reduce duplicate requirements in its two programs that pay incentives to health careproviders who use health information technology.

CMS should also reconcile areas in the two programs that are similar but inconsistent to relieve some of the reporting burden for participating physicians, it added. Those two programs are e-prescribing and electronic health records (EHRs).

Incentives For E-Prescribing

In 2009, the first year the e-prescribing program disbursed incentive payments, CMS paid out $148 million to about 8 percent of the approximate 600,000 eligible Medicare providers. From 2012 through 2014, CMS will decrease the amount of payments to providers who do not establish e-prescribing, the GAO said.

This year CMS will start paying incentives under the EHR program to qualifying Medicare providers.

Although GAO found similarities in the technology and reporting requirements for both programs, the government auditor said that the requirements of the two programs are inconsistent in several areas.

The EHR program provides incentives from 2011 to 2016 and introduces penalties beginning in 2015, while the e-prescribing program provides incentives from 2009 to 2013 and provides for penalties from 2012 to 2014, when the program ends. Both programs require providers to adopt and use technology that can perform similar e-prescribing-related activities.

The two programs have established separate reporting requirements related to e-prescribing, potentially requiring physicians to report to both programs from 2011 through 2014.

"This inconsistency between the programs has the potential to create uncertainty among physicians" as to what technology is most appropriate for them to invest in, said Linda Kohn, director of healthcare issues at GAO.

CMS said it will identify methods for aligning the two programs in the plan it is already required to develop by Jan. 1, 2012. That might be too late for physicians to avoid penalties from the e-prescribing program in 2013 since the requirements for avoiding penalties in 2013 would likely be proposed in July 2011 and finalized in November 2011.

Address: Centers for Medicare and Medicaid Services, 7500 Security Blvd., Baltimore, MD 21244; (877) 267-2323,

  This article was taken from:
The Executive Report on Managed Care

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