[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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