E-prescribing: Big business, labor, insurers lobby for mandatory e-prescribing bill

May 9, 2008

A bill in Congress that would require doctors to e-prescribe for Medicare patients or else take a pay cut has been endorsed by an impressive list of groups representing patients, employers, and insurers. But only one major physician organization has jumped on the bandwagon.

A bill in Congress that would require doctors to e-prescribe for Medicare patients or else take a pay cut has been endorsed by an impressive list of groups representing patients, employers, and insurers. But only one major physicianorganization has jumped on the bandwagon.

Forty-four organizations signed a May 1 letter to Congressional committee leaders in support of the legislation, and the breadth of the signatories mirrors the bi-partisan nature of the identical Senate and House bills. Consumer and labor groups include the AARP (formerly the American Association of Retired Persons), Consumers Union, and the AFL-CIO. The health insurance and pharmaceutical industries are well represented by the likes of the Blue Cross and Blue Shield Association, WellPoint, UnitedHealth Group, and the National Association of Chain Drug Stores. Twenty-two corporations and umbrella groups on the list are major purchasers of healthcare; they include General Motors, Ford Motor, AT&T, the National Business Group on Health, and the National Retail Federation.

The legislation they’re all endorsing is the Medicare Electronic Medication and Safety Protection Act, which sets a deadline of 2011 for doctors to electronically transmit their prescriptions to pharmacies for Medicare patients. Doctors who don't would receive 10 percent less in reimbursement for any related E&M service. Medicare could waive the penalty for hardship cases.

The May 1 letter to Congressional leaders from backers of the legislation states that e-prescribing can “reduce deadly and costly prescription medication errors” as well as save money for doctors, patients, payers and pharmacies alike. They sound like goals any physician would support, but the sole medical group that signed the letter was the American Medical Group Association, which represents large multispecialty groups.

In contrast, the AMA has called for voluntary adoption of e-prescribing along with ample federal funding. Likewise, the American College of Physicians has stated that it can’t endorse the legislation as-is because it doesn’t adequately address the barriers that doctors face in implementing e-prescribing, which it favors in principle. For one thing, the proposed federal subsidies for doctors may not be large enough, according the ACP. It also notes that an estimated 30 percent of pharmacies don’t accept e-prescriptions, forcing doctors to maintain a paper workflow as well as an electronic counterpart, which would be inefficient and costly.