Sunday, July 13, 2008

H.R.6331 Medicare Improvements for Patients and Providers Act of 2008

Here is an excerpt from the recently passed legislation: carrots, sticks and all.
I am surprised at small size of the initial bonus and the quickness with which it will be decreased.

Let's get some opinions. SV

The bonuses would seem to decrease over the years:

`(C) APPLICABLE ELECTRONIC PRESCRIBING PERCENT- For purposes of subparagraph (A), the term `applicable electronic prescribing percent' means--

`(i) for 2009 and 2010, 2.0 percent;

`(ii) for 2011 and 2012, 1.0 percent; and

`(iii) for 2013, 0.5 percent.';

While the penalalties would increase over the years (percent of fee schedule after penalty is applied):

ii) APPLICABLE PERCENT- For purposes of clause (i), the term `applicable percent' means--

`(I) for 2012, 99 percent;

`(II) for 2013, 98.5 percent; and

`(III) for 2014 and each subsequent year, 98 percent.

The Government will revisit the incentives/disincentives base upon several variables including:

(c) GAO Report on Electronic Prescribing- Not later than September 1, 2012, the Comptroller General of the United States shall submit to Congress a report on the implementation of the incentives for electronic prescribing established under the provisions of, and amendments made by, this section. Such report shall include information regarding the following:

(1) The percentage of eligible professionals (as defined in section 1848(k)(3) of the Social Security Act (42 U.S.C. 1395w-4(k)(3)) that are using electronic prescribing systems, including a determination of whether less than 50 percent of eligible professionals are using electronic prescribing systems.

(2) If less than 50 percent of eligible professionals are using electronic prescribing systems, recommendations for increasing the use of electronic prescribing systems by eligible professionals, such as changes to the incentive payment adjustments established under section 1848(a)(5) of such Act, as added by subsection (b).

(3) The estimated savings to the Medicare program under title XVIII of such Act resulting from the use of electronic prescribing systems.

(4) Reductions in avoidable medical errors resulting from the use of electronic prescribing systems.

H.R. 6331

1 comment:

philavine said...

Once again, fed gov is making my life more difficult. Altho I have been using ehr for 12 years now, the program (Easy Psychiatric REcord Keeper) obviously doesn't have erx capability. For yrs I've been printing out rx's, faxing often. DEA proposed regs of 6/28/08define e prescriptions as not including faxed written rx's. Does anyone on this blog know what the defs are for medicare? Looks like I'm gonna have to do a new program. As Will Rogers once said, "Progress used to be a good thing but it's gone on too long..."
I think the incentives suck, but will prolly go along as losing income is not my cup of tea. But of course if we all just ignore the incentives, they'll have to up the ante in '12.
The other thing I take issue with is the belief that erxing will reduce cost and reduce errors. I haven't seen any data on that and see how erxing in my hospital hasn't reduced errors that much. IMHO, the primary source of error is the decisions (or lack thereof) made by MDs, i.e. our own rx behaviors, not what gets produced on paper or electronically.