[Congressional Record Volume 153, Number 185 (Wednesday, December 5, 2007)]
[Senate]
[Pages S14788-S14789]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
By Mr. KERRY (for himself, Mr. Ensign, Ms. Stabenow, and Mr.
Martinez):
S. 2408. A bill to amend title XVIII of the Social Security Act to
require physician utilization of the Medicare electronic prescription
drug program; to the Committee on Finance.
Mr. KERRY. Mr. President, seven thousand Americans die every year
because of preventable adverse drug events. Tens of thousands of more
are injured. Meanwhile, of the three billion prescriptions that are
written each year, doctors report that nearly one billion of them
required a followup for clarity, costing our health care system
billions of dollars a year. That is why I am pleased to join my
colleagues Senator Ensign, Senator Stabenow and Senator Martinez to
introduce critical legislation to help bring our health care system
into the 21st century through electronic prescribing, e-prescribing, of
medications in the Medicare program.
The benefits of e-prescribing are clear and compelling. When a doctor
``writes'' an electronic prescription, a computer or handheld device
warns of potentially dangerous interactions or allergies or informs a
physician whether a particular drug is covered by a patient's
insurance. It also tells the physician whether a chemically identical
generic alternative is available at a fraction of the price. The path
to a more modern, accountable health care system starts with health
information technology. The path to robust health information
technology starts with e-prescribing.
This legislation would provide permanent funding for physician
payment bonuses in Medicare to help offset the costs of acquiring e-
prescribing systems and to incentivize the use of the
[[Page S14789]]
technology. The bill would also require all physicians in Medicare to
use e-prescribing starting in 2011--1 year later than the Institute of
Medicine recommended in their recent study. We have talked long enough
about using technology to stem perpetually rising health care costs and
poor quality, and our legislation takes an important step to do
something about it.
I want to give particular credit to Mark Merritt and his team at
Pharmaceutical Care Management Association, PCMA, for their hard work
and leadership. PCMA is responsible for a seminal study in this field,
which showed for the first time that broader adoption of e-prescribing
will not only save lives, but will also save billions of dollars for
patients, payers and taxpayers alike. Perhaps most importantly, PCMA
created a strong and diverse coalition of health care stakeholders to
advocate for this legislation, including business, labor, consumer
advocates, physicians, health plans, pharmacists, and drug
manufacturers. The PCMA-led coalition has worked diligently on Capitol
Hill in support of this important issue. They have educated Congress on
e-prescribing and are helping to make sure that we get the policy
right.
The Medicare E-MEDS Act gets it right. The standards and
interoperability for e-prescribing are in place; the technology is
affordable; and, most importantly, the dramatic benefits for patients
and health care purchasers--especially the Federal Government--are
overwhelmingly clear. This bill is a solid step towards addressing
these important issues in the delivery of our Nation's health care. It
is time that Congress act to save lives and increase efficiency in
America's health care system.
Mr. President, I ask for unanimous consent that the text of the bill
be printed in the Record.
There being no objection, the text of the bill was ordered to the
printed in the Record, as follows:
S. 2408
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Electronic
Medication and Safety Protection (E-MEDS) Act of 2007''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Patient safety is an important issue and a priority
among patients, providers, insurers, businesses, and
government entities alike.
(2) Adverse drug events are defined by the Institute of
Medicine as ``any injury due to medication''.
(3) According to the Institute of Medicine, more then 1.5
million preventable adverse drug events occur every year in
the United States.
(4) Studies indicate that at least 530,000 preventable
adverse drug events occur each year among the Medicare
population, and cost the Federal Government upwards of
$887,000,000, or $1,983 per person.
(5) Electronic prescription drug programs, or e-
prescribing, provide for the electronic transmittal of
prescription information from the prescribing health care
provider to the dispensing pharmacy and pharmacist.
(6) Electronic prescribing provides formulary and coverage
information before a prescription is written to better inform
the patient and prescriber of lower cost options, including
generics.
(7) E-prescribing can help to eliminate medical errors,
injuries, hospitalizations, and even death that can result
from illegible prescriptions and bad drug interactions, in
addition to reducing patient medication non-adherence.
(8) The Institute of Medicine recommends that all
physicians create a plan to implement and use e-prescribing
technology by 2010.
SEC. 3. INCENTIVES FOR USE OF E-PRESCRIBING UNDER MEDICARE.
(a) Bonus Payments.--Section 1833 of the Social Security
Act (42 U.S.C. 1395l) is amended by adding at the end the
following new subsection:
``(v) Incentive Payments for Physician Use of E-
Prescribing.--
``(1) One-time bonus for start-up costs.--
``(A) In general.--If the Secretary determines, based upon
coding in claims submitted under this part over a duration
specified by the Secretary, that a physician meets a
threshold volume or proportion (as specified by the
Secretary) of claims for physicians' services for individuals
enrolled under this part that--
``(i) are classified (under section 1848) as evaluation and
management services;
``(ii) include the making of a prescription that could
under law be made using the electronic prescription drug
program; and
``(iii) use the electronic prescription drug program for
such prescription,
the Secretary shall make a payment to the physician, in
addition to any other payment under this part, of the amount
specified in subparagraph (B). Not more than one payment may
be made under this subsection with respect to any physician.
``(B) Amount.--The payment amount under subparagraph (A)
shall be, in the case of a physician that meets the
conditions of subparagraph (A) for a period that begins
during--
``(i) 2008 or 2009, $2,000;
``(ii) 2010 or 2011, $1,500; or
``(iii) 2012 or a subsequent year, $1,000.
``(2) On-going bonus for use of e-prescribing.--
``(A) In general.--If the Secretary determines, based upon
coding in claims submitted under this part over a period
specified by the Secretary, that a physician uses the
electronic prescription drug program for prescribing at least
a threshold volume or proportion (as specified by the
Secretary) of claims for physicians' services for individuals
enrolled under this part, in addition to the amount of
payment that would otherwise be made under this part for
physicians' services by the physician that are classified as
evaluation and management services under section 1848, there
also shall be paid to the physician an amount equal to 1
percent of the allowed charges for such services. In applying
the previous sentence, there shall not be taken into account
claims for prescriptions written for controlled substances
which may not under law be prescribed using the electronic
prescription drug program.
``(B) Application to physician shortage bonuses.--The
additional payment under this paragraph shall be taken into
account in applying subsections (m) and (u).
``(3) Auditing.--Provisions applicable to the auditing of
claims for payment and enforcement of false claims under this
part shall apply to claims for payment under this subsection.
``(4) Electronic prescription drug program defined.--In
this subsection, the term `electronic prescription drug
program' means the program established under section 1860D-
4(e).''.
(b) Requirement for Use of E-Prescribing.--Section 1848(a)
of such Act (42 U.S.C. 1395w-8(a)) is amended by adding at
the end the following new paragraph:
``(5) Adjustment in fee schedule for failure to use e-
prescribing.--
``(A) In general.--Subject to subparagraph (B), effective
for physicians' services furnished on or after January 1,
2011, in the case of such services--
``(i) that are classified as evaluation and management
services under this section; and
``(ii) in connection with which there was one or more
prescriptions made that could have been made, but were not
all made, under the electronic prescription drug program,
the fee schedule amount otherwise applicable under this
section shall be reduced by 10 percent.
``(B) Waiver.--The Secretary may waive the application of
subparagraph (A) until January 1, 2012, or January 1, 2013,
as specified by the Secretary, in cases of demonstrated
hardship or unforeseen circumstances specified by the
Secretary.''.
SEC. 4. REPORTS ON E-PRESCRIBING.
(a) CMS Report.--
(1) In general.--Not later than 2 years after the date of
the enactment of this Act, the Administrator of the Centers
for Medicare & Medicaid Services shall submit to Congress a
report on progress on implementing e-prescribing under the
Medicare electronic prescription drug program under section
1860D-4(e) of the Social Security Act (42 U.S.C. 1395w-
104(e)).
(2) Items included.--Such report shall include information
on--
(A) the percentage of Medicare physicians that utilize the
electronic prescription drug program;
(B) the estimated savings resulting from the use of e-
prescribing; and
(C) progress on reducing avoidable medical errors resulting
from the use of e-prescribing.
(b) GAO Report.--
(1) In general.--Not later than 2 years after the date of
the enactment of this Act, the Comptroller General of the
United States shall submit to Congress a report on the impact
of implementation of such program on physicians.
(2) Items included.--Such report shall include information
on--
(A) factors influencing the adopting of e-prescribing by
physicians; and
(B) the impact of this Act on physicians practicing in
individual or small group practices and on physicians
practicing in rural areas.
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