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Groups, Lawmakers Push for E-Prescribing in Medicare Package

By Mary Agnes Carey, CQ HealthBeat Associate Editor

December 5, 2007 -- A coalition of consumer and health care groups joined forces Wednesday to support legislation that would require Medicare physicians to issue prescriptions electronically by 2011 or face financial penalties.

The measure would foster the adoption of e-prescribing by providing permanent Medicare funding for payment bonuses to physicians who acquire e-prescribing technology. In addition, for every Medicare prescription a doctor writes electronically, they would be paid an extra 1 percent bonus.

"E-prescribing will save money, save time, save doctors from piles of paperwork, and most importantly, save lives," said one of the measure's co-sponsors, Sen. John Kerry, D-Mass. "Deaths and injuries from hand-written prescriptions could be nearly eliminated if e-prescriptions were adopted on a wide scale. We need to seize this bi-partisan opportunity and make this common sense reform a reality now."

Among its provisions, the measure would provide permanent Medicare funding for one-time grants to physicians to help offset the start-up costs to physicians of acquiring and implementing e-prescribing technology, and provide permanent Medicare funding for payment bonuses to physicians for use of e-prescribing.

Under the legislation, physicians would be required, as of Jan. 1, 2011, to write their Medicare outpatient prescriptions electronically. Physicians that continue to write prescriptions by hand would face a per-claim financial penalty. The measure also would give the secretary of Health and Human Services the authority to grant one- or two-year hardship waivers for physicians who face particular difficulties in acquiring and implementing e-prescribing, especially those from rural areas or very small or solo practices.

Former House Speaker Newt Gingrich, who heads the Center for Health Transformation, said Wednesday that Americans are ready for e-prescribing. "With Americans using ATM cards everyday in this country and abroad, we believe they are prepared for the massive benefits providing by an electronic prescriptions system—a 21st century system," Gingrich said.

In addition to Kerry, co-sponsors of the measure include Sen.. Debbie Stabenow, D-Mich., and Sen. John Ensign, R-Nev. In the House, co-sponsors include Reps. Allyson Y. Schwartz, D-Penn., and Jon Porter, R-Nev.

Proponents of the legislation, citing Institute of Medicine figures, said that as a result of prescription errors, American hospital patients suffer 1.5 million injuries each year and medication errors will kill at least 7,000 Americans in 2007. Of the more than three billion prescriptions written each year, doctors report nearly one billion require a follow-up between providers and pharmacies for clarification. The health-care system costs are in the billions.

According to the firm SureScripts, 35 million prescription transactions were sent electronically in 2007 between pharmacies and prescribers, with more electronic prescriptions transmitted in the first three quarters of 2007 than in 2004, 2005 and 2006 combined.

In a letter sent Wednesday to the Senate, Consumers Union Senior Policy Analyst Bill Vaughan said the group wants Congress to implement e-prescribing in Medicare and Medicaid and urged that the legislation be included in any Medicare package. Senate Finance Committee Chairman Max Baucus, D-Mont., announced Wednesday afternoon he is scrapping plans for a markup of Medicare legislation and instead will negotiate directly with the House.

The Bush Administration has urged that physicians be required to adopt health care information technology as a part of any Medicare package that would prevent a scheduled cut in Medicare physician payments.

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