House, Senate Bills Promote E-Prescribing

Medicare physicians would be required to adopt electronic prescribing by 2011 or face possible financial penalties under legislation recently introduced in the House and Senate.

Sen. John Kerry, D-Mass., and Rep. Allyson Schwartz, D-Pa., have introduced legislation that, if passed, would use financial incentives and disincentives to encourage the adoption of electronic prescribing, or e-prescribing, under Medicare.

The bills, S.B. 2408 and H.R. 4296, (at the THOMAS Web site, type "S 2408" or "HR 4296" in the search box after selecting "Bill Number") respectively, include provisions for grants to physicians to help with the start-up costs of acquiring and implementing e-prescribing systems. They also propose a system for providing permanent Medicare bonuses to physicians who use the technology.

If enacted, the legislation would give physicians a 1 percent bonus payment for every claim submitted that included an e-prescription.

The legislation, known as the Medicare Electronic Medication and Safety Protection Act, also would impose a per-claim financial penalty on physicians who continue to write prescriptions by hand as of Jan. 1, 2011. However, the legislation would give HHS the authority to grant one- or two-year hardship waivers for physicians who are unable to implement e-prescribing for financial or other reasons -- exemptions specifically designed to help solo and rural physician practices.

"Electronic prescribing does save lives, it does save money and it is an enormously effective way of beginning to move toward the information technology age," said Kerry during a Dec. 5 press conference in Washington announcing the introduction of the legislation.

Citing a July 2006 report brief from the Institute of Medicine (4-page PDF; About PDFs) that attributes 7,000 deaths and 1.5 million injuries each year to prescribing errors, Kerry said it is "inexcusable" that the U.S. health care system has not moved more quickly to adopt e-prescribing.

"There are huge savings on the other side of this -- billions of dollars of savings as a consequence of avoiding those hospitalizations or injuries," asserted Kerry during a question-and-answer segment of the press conference.

Former House Speaker Newt Gingrich, founder of the Center for Health Transformation, also spoke at the press conference, saying that e-prescribing "saves lives and saves money." He also said that physicians are not "adopting it as rapidly as they could."

'The technology is very ripe and very available," said Gingrich.

Kerry and other proponents of the legislation pointed out that this year's e-prescribing measure has broad bipartisan support, making it more likely to pass Congress than past e-prescribing initiatives, which have lacked such support.

The Bush administration also has come out as a strong proponent of e-prescribing. In a recent posting to his Web blog, HHS Secretary Michael Leavitt said "any new bill overriding the SGR (sustainable growth rate) law should require physicians to implement health information technology that meets department standards for interoperability in order to be eligible for higher payments from Medicare."

"Such a requirement would accelerate adoption of this technology considerably and help to drive improvements in health care quality as well as reductions in medical costs and errors," Leavitt added.