E-Prescribing Bonus: A Double-Edged Sword?

The law that Congress recently passed that rolled back Medicare fee cuts contained some other goodies for doctors. Among the less publicized benefits is a bonus for doctors who prescribe drugs electronically instead of using paper prescriptions. Starting next year, doctors who go the e-prescription route will get a bonus of 2% of all the Medicare services they provide during the year. In 2011, the bonus payment will drop to 1% and will eventually phase out by 2013. In the meantime, doctors who cling to paper-only prescriptions will be have their Medicare payments cut by 1% starting in 2011, a penalty that will go up to 2% in 2013.

The extra payments are a good first step, say officials of the American Medical Association, but the financial incentives probably won’t be enough to compensate doctors for installing a costly e-prescribing system. CMS, however, pegs the cost of switching to electronic prescribing at an estimated $3,000 per doctor, plus maintenance fees of $80 to $400 a month, and maintains that the 2% bonus payment would cover these costs in many cases.

There are other problems, says the AMA, one of which has to do with doctors who prescribe drugs on the Drug Enforcement Administration’s controlled substance list. Although the DEA is proposing to lift a longstanding ban on e-prescribing controlled substances, a move that the AMA applauds as overdue, there are still logistical hurdles to be overcome. One example is the requirement that doctors who prescribe controlled substances carry a portable data drive to prove their identity when using an e-prescription system.