Medicare Compliance & Reimbursement

McClellan says agency wants widespread use 'as soon as possible'

To make good on the Bush administration's promise of substantial investment in health information technology, the Centers for Medicare & Medicaid Services is gearing up to take electronic prescribing off the back burner.

Seven months ahead of the deadline set by the Medicare Modernization Act, new HHS Secretary Mike Leavitt announced Jan. 27 that proposed rules should have major electronic prescribing standards in place by the time Part D rolls out in January 2006.

The technology, which transmits prescriptions electronically to the patient's pharmacy, would allow providers instant access to a patient's eligibility and medication history. CMS says e-prescribing would cut health costs and improve care by eliminating hard-to-read physician handwriting and by automating drug interaction and allergy checks.

Although the reform bill requires participating drug plans to support e-prescribing, the bill doesn't require physicians and pharmacies to use the technology. Secretary Leavitt predicted that firm guidance on how to communicate and interpret health data would "make e-prescribing more attractive."

Adopted from the National Committee on Vital and Health Statistics' (NCVHS) recommendations, the proposed regulations standardize:

 transactions between doctors and pharmacies for new prescriptions, and protocols related to prescription refills, changes and cancellations;

 eligibility and benefits inquiries and responses between doctors and prescription drug plans, as well as pharmacies and Part D sponsors; and

 formulary and benefit coverage information. Comments will be accepted through April 5, 2005. The proposed rule is scheduled for publication in the Feb. 4 Federal Register.