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Bill requires e-prescribing for Medicare, pay cuts for non-compliance

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Identical Senate and House bills introduced last month would require you to electronically transmit prescriptions for Medicare patients to the pharmacy starting in 2011 or else take a pay cut.

Identical Senate and House bills introduced last month would require you to electronically transmit prescriptions for Medicare patients to the pharmacy starting in 2011 or else take a pay cut.

It'd be inaccurate to call the bills an unfunded mandate, however. The legislation authorizes a one-time grant to physicians to offset start-up costs of e-prescribing (an estimated $2,000 to $3,000, according to a spokesperson for the House bill sponsor). The federal grant would be $2,000 for doctors implementing the technology in 2008 or 2009, $1,500 in 2010 or 2011, and $1,000 in 2012 and afterward. In addition, Medicare would tack on a 1-percent bonus for any evaluation and management service performed in conjunction with an e-prescription.

However, doctors who don't e-prescribe would suffer a 10-percent reduction in reimbursement for any related E&M service. Medicare would waive the penalty for practices that can demonstrate hardship.

Lest there be any misunderstanding, faxing a prescription to a pharmacy won't satisfy the e-prescribing mandate envisioned in the House and Senate bills. In true e-prescribing, a doctor's computer transmits the Rx directly to the pharmacy's computer through a technology called electronic data interchange, or EDI.

The bi-partisan legislation, called the Medicare Electronic Medication and Safety Protection Act, promises to set off a lobbyist war. Although the AMA reportedly has not yet taken a position on the House and Senate bills, the organization has called for voluntary adoption of e-prescribing coupled with generous federal funding. In contrast, a group called the Pharmaceutical Care Management Association, which represents pharmacy benefit managers, has run print and television ads urging Congress to mandate e-prescribing for the sake of saving lives.

Sen. John Kerry (D-MA) is the sponsor of the Senate bill (S. 2408) while Rep. Allyson Schwartz (D-PA) is the sponsor of the House bill (H.R. 4296). The Senate bill has nine co-sponsors; the House version, 11.

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