WASHINGTON – The Centers for Medicare and Medicaid Services is proposing key changes to quality reporting and e-prescribing qualifications for physicians.

The proposed changes aim to simplify physician qualifications for e-prescribing incentives and to offer practices incentives for using an electronic health record-based quality reporting system.

“The AAFP commends CMS for simplifying the reporting requirements for the electronic prescribing and the Physician Quality Reporting Initiative,” said Lori Heim, MD, president of the American Academy of Family Physicians. “With simplification, it will encourage more physicians to adopt EHR systems and e-prescribing, which will help improve efficiency nd reduce the potential for medical errors, duplication of services and fragmentation of care.

The Physicians for Quality Report-ing Initiative began in 2007, and is a voluntary program that provides financial incentives to those who meet the qualifications of quality reporting during a specified period. However, without Congress support, time is limited, said Robert Bennett, government affairs representative for physician payment and quality issues at the Medical Group Management Association.

“Right now, successful participants of the program are eligible for 2 percent of full reported charges,” said Bennett. “However, incentive money runs out at the end of 2010. The Medicare Improvements for Physicians and Patients Act, passed in 2008 continues these positive incentives through 2009 to 2010. If Congress does nothing, incentives for physicians participating in PQRI will end with 2010.”

At the start of PQRI, about 16 percent of eligible care professionals tried to qualify for the incentives, said Bennett. According to CMS reports, only 8 percent had actually succeeded in receiving incentive money.

The new goal of the Medical Group Management Association is to move practices to an EHR-based reporting system. But, there is a catch, Bennett said. “CMS believes that there is a need to push physicians to submit quality reporting through the use of an EHR,” Bennett said. “The other side of that is most physician practices out there don’t have access to EHRs that have reporting capabilities. MGMA is pushing CMS to promote the use of EHRs with the PQRI program.”

In response, CMS is holding a closed certification process to select a vendor that will provide practices and hospitals with a qualified reporting EHR solution, Bennett said.

“My personal prediction would be that sometime in the early new-year, the agency will announce which companies are the new qualified PQRI EHR vendors.”

CMS also plans to simplify the terms for successful e-prescribing in practices, said Robert Tennant, senior policy adviser at MGMA.

Until now, physicians who wanted to take advantage of e-prescribing incentives were required to submit data of all claims sent that were accompanied by one of three “G” codes, said Tennant.

“CMS has simplified this to one G code: I successfully e-prescribe,” said Tennant. “Physicians need to show they e-prescribe 25 times during a payment period. You could possibly make that in one day, so they have significantly simplified the qualifications to push physicians to e-prescribe.”

CMS is now looking to streamline PQRI and e-prescribing to make it easier for physicians to adopt both. One barrier still remains.

“Anytime you streamline a process it makes it harder for physicians not to adopt. There is one barrier, however. The Drug Enforcement Administration prohibits the e-prescribing of controlled substances. This is challenging issue. The DEA is being pressured to change their stance on controlled substances to allow full e-prescribing adoption.”

Recently, the DEA has authorized a new pilot to test the e-prescribing of controlled substances with the use of secure USB drives, said Tennant. The location of the pilot is still to be announced.

Tennant says there is still a lot of work to be done in regard to PQRI and e-prescribing adoption.

“Change is difficult,” he said. “You have a lot physicians practicing a certain way for many years. It’s not about the money, it’s about the hassle factor of implementing something this large while at the same time seeing patients.”