Medicine In The News
Physicians representation continues to grow in congress based on
the recent elections. We have 20 physicians in congress, a new record. Only two physicians were not re-elected. All but Jim McDermot and Vic Snyder are republicans. In the
2010 elections we have elected to the senate ophthalmologist Rand
Paul MD (R, KY), and Ob-Gyn Tom Coburn (R, OK) was re-elected.
Elected to the house were Mike Fallon MD (R, CO, emergency
medicine; Larry Bucshorn, MD (R, IN) thoracic surgery; Andy Harris
MD (R Maryland) anesthesia; Joe Heck DO (R NV)emergency medicine;
Nan Hayworth MD (R, NY) internal medicine, Scott DesJarlais MD ( R,
TN) family medicine. Re-elected to the house were Charles
Boustany Jr MD (R, LA) cardiovascular surgery; Paul Broun MD, (R,
GA) family medicine; Michael Burgess MD, (R, TX) ob-gyn; Bill
Cassidy MD, (R, LA) GI; John Fleming MD (R, LA) family medicine;
Phil Gingrey, MD (R,GA) ob-gyn; Jm McDermott MD (D, WA) psychiatry;
Ron Paul MD ( R, TX) ob-gyn; Tom Price (R, GA) orhopedics, Phil Roe
(R, TN) ob-gyn; Vic Snyder MD (D, AR) family medicine
Physicians fared well in the 2008 US elections. We will have a
total of 14 physicians in the new congress, the most we have ever
had. The final Medicare fee schedule for 2009 will show a 1.1% pay
increase. We originally were going to suffer a 5% pay cut in 2009 ,
on top of the 10.6 percent cut for 2008 which congress overturned.
In addition to the pay increase there will be bonus payments of 2%
for physicians who prescribe medications electronically for their
Medicare patients, and another 2% bonus for doctors who participate
in the Physician Quality Reporting Initiative. There is a major bipartisan congressional push to make electronic medical record systems mandatory. Its advocates cite cost
savings to the government, the use of EMR data in implementing pay
for performance, and reductions in medical errors. No one is saying
how we are supposed to pay for the EMR systems, which average
$15,000-$30,000 start up costs per physician, and about
$3,000-$6,000 yearly maintenance. The potential for invasion of privacy of both patients and doctors
by commercial EMR systems is huge and has been largely overlooked.
Data mining companies have successfully argued in two state courts
that they have a constitutional right to compile and sell confidential patient prescription information.
Top Stories 11/19/08
- Federal Appeals Court Upholds Prescription Privacy
The federal district appeals court in
Boston upheld a New Hampshire law that blocked the sale of doctor
specific prescription information. This information was compiled
by data mining companies and sold to pharmaceutical companies.
The pharmaceutical companies were thus armed with precise
current prescription information which they used to target
physicians that weren't prescribing their product, or to
increase market share. By increasing the use of expensive name
drugs, the cost to the state Medicaid programs were increased.
The purpose of the New Hampshire law, (and similar laws passed
in Maine and Vermont), was to block this practice. This would
save the states money and improve physician and patient privacy.
According to the opinion written by United States Court of
Appeals Judge Bruce Marshall Selya the buying and reselling of
prescription information was “mind-boggling” . “The record
contains substantial evidence that, in several instances,
detailers armed with prescribing histories encourage the
overzealous prescription of more costly brand-name drugs
regardless of both the public health consequences and the
probable outcome of a sensible cost/benefit analysis." It is
expected that this ruling will also apply to Maine. In both
Maine and New Hampshire prescription privacy laws were
overturned by state federal courts. In Maine a decision issued
12/21/07 by Judge John Woodcock said the privacy law would
prohibit "the transfer of truthful commercial information" and
"violate the free speech guarantee of the First Amendment."
Bangor Daily News.
There is no constitutional guarantee of a right to privacy, it
is an implied right. Thus in prior decisions the
constitutionally guaranteed right to free speech of the Data
Mining companies was considered more important than the implied
right to privacy of patients and their physicians.
- Physicians Win New Seats In US Congress 11/18/08
There will be a total of 14 physicians in the new US congress,
12 in the House of Representatives, and two in the Senate.
There will be five Ob-gyn specialists serving in congress. Senator Tom Coburn, MD (R, Okla.), ob-gyn was not up for relection.
Newly elected physician
members of congress are: Rep. Bill Cassidy, MD (R, La.), family medicine;
Rep. Parker Griffith, MD (D, Ala.), medical oncology; and
Rep. Phil Roe, MD (R, Tenn.), ob-gyn. Reelected were Sen. John Barrasso, MD (R, Wyo.), orthopedic surgery;
Rep. Charles Boustany, MD (R, La.), cardiovascular surgery;
Rep. Paul Broun, MD (R, Ga.), family medicine;
Rep. Michael Burgess, MD (R, Texas), ob-gyn;
Rep. Phil Gingrey, MD (R, Ga.), ob-gyn;
Rep. Steve Kagen, MD (D, Wis.), internal medicine;
Rep. Jim McDermott, MD (D, Wash.), psychiatry;
Rep. Ron Paul, MD (R, Texas), ob-gyn;
Rep. Tom Price, MD (R, Ga.), orthopedic surgery;
and Rep. Vic Snyder, MD (D, Ark.), family medicine.
Retiring is Rep. Dave Weldon, MD (R, Fla.), internal medicine.
Unfortunately our physician representatives don't vote the same
way on health care issues, which dilutes our voice. For example
democrat Jim McDermott has been an outspoken proponent of a
single payer universal healthcare system, whereas many of his
republican colleagues have been outspoken critics of such a
system. Hopefully they can all agree on the need for malpractice
reform, especially with five ob-gyns serving in congress.
- Michigan Voters Legalize Growth, Distribution,
Sale, and Use of Medical Marijuana 11.16.08
voters passed a measure legalizing the growth, distribution, and
possession of up to 2.5 ounces of marijuana by registered
patients. Patients must have a written certification from a
physician certifying that they have a debilitating condition
which can be alleviated by marijuana use. Patients may then
designate a primary caregiver who is allowed to grow and
distribute the marijuana. The caregiver is allowed to assist up
to five patients, and each caregiver may posses up to 2.5 ounces
of marijuana and 12 plants per patient they are assisting. The
caregivers are allowed to sell the marijuana to registered
patients. The caregivers must not have been convicted of prior
drug offenses, and must register with the state. Michigan joins
14 other states which have decriminalized marijuana. These state
laws are in conflict with federal law which bans the sale,
distribution, possession, or use of the drug. The
Controlled Substances Act of 1970 classifies marijuana as a
Schedule I drug, ie, it has a high potential for abuse and no
acceptable medical use.
- Health Insurers To Launch Medical Tourism Programs
An article in
Business Week stated that Health insurer WellPoint is setting up a pilot program that send patients to India for
The program can save the insurer thousands of dollars per
procedure and give WellPoint extra clout at the bargaining table with U.S.
physicians and hospitals.
About 750,000 Americans headed abroad last year for major health care.
Aetna Inc. launched a medical tourism pilot program earlier this year.
Medical tourism involves traveling to another country for elective care
that can include dental procedures, hip replacements, cosmetic surgery, bariatric
surgery, and even heart bypasses or heart valve replacements.
- Insurance Companies Know What In Your Patients'
Medicine Cabinets 8/04/08
An article in
Business Week and a similar article in the
Washington Post detailed how insurance companies such as
Aetna, Humana, United Healthcare, Blue Cross, and others
routinely use prescription profiling services. The information
is used to deny insurance to people who are considered high
risk of incurring medical expenses. Prescriptions for hypertension, diabetes, and mental
health medications are red flags for insurers. The companies
that sell this information include
- Congress Overrides Presidents Veto, Blocks Medicare
pay cut 7/15/08
On July 15 Both houses of congress overrode
President Bushes veto, enacting an 18 month patch on Physician
Medicare payments. The money will come from
Medicare Advantage programs, which charge the federal
government a premium over medicare rates, and which are a major
source of profits for the HMO industry. Instead of a 10.6% pay
cut, we will get a 0.5% pay increase for the next 18 months,
then face even larger cuts. Also in the "Medicare Improvements
For Patients And Physicians Act of 2008" was a mandate for
e-prescribing, with both a carrot for early adapters, and a
stick for late adapters. Starting in 2009, physicians will receive incentives of up to 2% of their Medicare payments for using electronic prescribing to place
medication orders on Medicare approved drugs. The bonus will
decrease to 0.5% in 2013. Starting in 2011, doctors will be
required to use e-prescribing in Medicare and there will be a 2%
penalty against Medicare payments for those physicians that
don't use e-prescribing.
- E-Prescribing: Following The Money Path From Ex
Medical Economics by Robert Lowes details how the same Bush
administration officials who led the battle to force doctors to
implement electronic prescribing now stand to benefit
financially from e-prescribing mandates. Some of the same people
who criticized drug companies from giving out inducements to
doctors are affiliated with Prematics, an e-prescribing company
which gives out wireless hand held computers to doctors who
adapt their software. Ex-officials involved with Prematics
David Brailer MD, the former Bush administration National
Coordinator For Information Technology, former Health and Human
Tommy Thompson and former
Sen. John Breaux from Louisiana.
An excellent article in
Proposed Law Will Hold Data Mining Companies
Accountable To HIPAA 5-28-08
Under current law HIPAA
privacy regulations apply to doctors, hospitals, health insurance
companies, and medical billing companies. Data mining companies are
exempt. Data mining companies are euphemistically called Health
Information Exchanges (HIE) or Regional Health Information
Organizations (RHIO). A proposed law will hold these entities
accountable. It will also require any physician or hospital with
electronic medical records (EMR) to keep a log of any patient
information disclosures. The proposed law also will also require
Personal Health record Vendors (ie, Microsoft, Google) to disclose
any privacy breeches.
Dingell Proposed Law Memorandum
- New Study On Relationship Between Outcome and
Surgical Volume 5-02-08
Surgical volume is being increasingly used as a marker of physician quality.
A recent Swedish study published in the
British Medical Journal questions this practice. For
physicians who perform less than five inguinal hernia repair
surgeries per year, the risk of recurrence was increased.
However, beyond five procedures per year, there was no
relationship between recurrence rates and volume. Thus there
appears to be a threshold effect, and not a proportional
relation between surgical volume and quality.
- CMS to Implement 10.6% Cut Unless Congress Acts
The Centers for Medicare and Medicaid Services (CMS) announced in Transmittal 312 (February 1, 2008) that if Congress does not pass legislation regarding the sustainable growth rate (SGR) formula on which Medicare physician payments are based, the current conversion factor (CF) in the Medicare Physician Fee Schedule (MFS) of $38.0870 will be reduced to $34.0682
(a 10.6 reduction) effective on July 1, 2008.
Senate Finance Committee Chair Max Baucus (D-MO) is working on legislation to address the
scheduled Medicare physician pay cut , as well as the additional 10.1% cut that would take place January 1, 2009. In a Medicare package he plans to introduce directly on the Senate floor by mid-May, Senator Baucus has stated he favors applying an 18-month fix to the Medicare payment system and possibly providing a 1.1% rate increase during that period. Additional priorities Senator Baucus has outlined for his proposed legislation include:
Extra incentives to get health care providers to work in rural areas.
An electronic prescribing provision that would provide incentives for physicians to use e-prescribing tools and electronic medical records.
An expansion of the Physician Quality Reporting Initiative program.
- Bill Delaying Medicare Physician Fee Reductions
Progresses In Senate 4-07-08
Senate Finance Committee Chair Max Baucus (D-Mont.) on Thursday said he intends to send a bill
correcting the scheduled reduction in Medicare physician fees
straight to the Senate floor. The American Medical Association
is lobbying for a bill sponsored by Sen. Debbie Stabenow
(D-Mich.) that would increase physician fees by 1.8% for 18
Kaiser Daily Health Reports
- CMS Announces 3.6 Percent Rate Increase For
Medicare Advantage 4-03-08
The HMO controlled
Medicare advantage plans already cost the government
significantly more than traditional Medicare
NY Times. They are also the main source of profits for
companies such as Humana, and United. Today the Centers For
Medicare Services announced a 3.6% fee increase for these
already highly profitable plans.
- Neuroleptics Worsen Alzheimers 4-01-08
practice is to give nursing home patients antipsychotic
medications to reduce aggressive behavior and make them more
British study has found that antipsychotic drugs worsen the
cognitive decline of nursing home patients with Alzheimers. The neuroleptics
analyzed were thioridazine (Melleril), chlorpromazine (Largactil), haloperidol (Serenace), trifluoperazine (Stelazine) and risperidone (Risperdal).
The death rates were also higher for nursing home patients on
antipsychotics. In the US, federal rules that took effect
October 2007 require nursing homes,to use antipsychotic drugs
only when medically necessary, to document the medical necessity
and to make every effort to reduce the dose of the drugs.
- CMS Releases Hospital Report Cards For Consumers
The Centers for Medicare & Medicaid Services (CMS) has added
consumer survey information to its Hospital Compare website for Medicare
beneficiaries. The site now includes the results of patient care surveys, as well as information on pricing and elective procedure volumes at hospitals.
The website already offered 26 measures to assess the quality of care in acute care hospitals.
There is also information on the average medicare payment made
for a range of procedures. The information is available at
- Germany To Introduce Centralized Electronic
Health Records Despite Doctor Opposition 3-27-08
Germany will introduce an Electronic Health Card system in
April, despite doctor opposition. According to the British
Medical Journal, the German Medical Association issued a
press release earlier this month that claimed that patient data
stored on central servers would not be secure and would be open
for commercial exploitation. "Patients are not commercial
products," the press release declared. The German physicians
don't oppose Electronic Health Records, rather they oppose the
storage of health information on centralized servers. German
physicians have proposed an alternative whereby patient
information is stored on encrypted USB drives given to each
patient, and not on centralized servers.
E-Health Insider Security breeches of centrally secured
electronic health records have been a recurring problem in
Great Britain. A recent security breech of 25 million people
in the children's benefit database has an estimated street value
of $3 Billion US dollars.
BBC News. In the US, HIPAA privacy laws apply to doctors and
hospitals, but not commercial entities, thus Health information
can be freely sold even without a security breech.
HIPAA: Intent Versus Reality
- Were Doctors Being Bribed By Orthopedic Device
A long-running federal investigation
into the orthopedic device industry’s suspected kickback
payments to hip and knee surgeons now has the doctors in the
crosshairs. The investigation by Newark US attorney General
Christie resulted in a 311 million dollar settlement against five
manufacturers of orthopedic devices. The manufacturers are
required to publicly list all payments to consulting physicians.
The settlement sets a $500 per hour cap on physician consulting
Times The settlement has proven to be a bonanza for attorney
general Christie's ex boss, US attorney General Ashcroft. His
firm is being paid to monitor the settlement. In order to insure
that doctors aren't being paid more than $500 an hour as
consultants, Ashcroft's firm will get a multimillion dollar
monthly retainer and bill time at $895 per hour.
Ashcroft's D.C.-based firm is poised to collect more than $52
million in 18 months, among the biggest payouts reported for a
federal monitor. Disclosed in SEC filings, the arrangement pays Ashcroft Group Consulting Services an average monthly fee between $1.5 million and $2.9 million. The figure includes a flat payment of $750,000 to the firm's "senior leadership group," individual legal and consulting services billed at up to $895 an hour, and as much as $250,000 a month for expenses including private airfare, lodging and meals.
Newark Star Ledger
- US Senator Introduces Bill To Eliminate Medicare Physician Fee
Schedule Cuts 3-13-08
A bill has been introduced into the Senate that would eliminate the nearly 11 percent Medicare physician reimbursement cuts scheduled for July 1.
Sen. Debbie Stabenow, D, Mich., introduced the "Save Medicare Act of 2008" on March 13. The bill (S. 2785) proposes to replace the scheduled 10.6 percent cut with a 0.5 percent update for the second half of 2008 and a 1.8 percent update for 2009.
Stabenow's bill has been submitted to the senate finance committee.
Health Imaging News
- New Hampshire Defeats Medical Privacy Bill 3-13-08
The New Hampshire state senate defeated a bill which would have
extended federal HIPAA privacy requirements to businesses such as software
vendors, drug companies, and data mining firms. The bill also would
have allowed patients to place additional restrictions on their
records, and would have required that the hospital produce an audit
trail, at the patient’s expense, detailing who had access to a
patient’s medical information. Hospitals opposed the bill saying
that it would establish another costly layer of bureaucracy.
New Hampshire Business Review
- Insurer Finds That EMR is Not Worth The
Cost To Doctors 3-10-08
Blue Cross of Massachusetts
has concluded that the financial benefits of an Electronic
Medical Record system are not worth the cost to doctors. Thus
they will not require EMR for physicians to participate in its
bonus program. They have reached a different conclusion for
hospitals, and concluded that an electronic order entry system
for doctors orders would prevent enough medication errors to
make the system economically viable in 26 months. The AMA has
taken the position that physicians need financial subsidies in
order to encourage widespread adoption of EMR systems.
Proposed Massachusetts Law Would Fine Doctors $5,000 for
Accepting Drug Company Pens 3-04-08
senate president Therese Murray has proposed a law that would ban
all gifts to doctors from drug companies, including pens. Drug
samples could still be given. The new law calls for a $5,000 fine
for violations. State senator Mark Montigny (D), castigated drug
companies for hiring "former beauty queens and cheerleaders" as sales
reps to wine and dine doctors and induce them to prescribe brand
name drugs that may not be cost effective. The law also
mandates physician implementation of electronic health records.
NY Attorney General Issues Subpoenas Against Aetna,
Cigna, Empire Blue Cross, United Healthcare 2-13-08
attorney general Andrew Cuomo issued subpoenas against the largest
healthcare insurers today. These companies used a fraudulent scheme
to set customary and reasonable charges artificially low,
causing consumers to pay excessive out of pocket fees. At the center of the scheme is
United Healthcare's subsidiary Ingenix, the nation’s largest provider
of healthcare billing information, which serves as a conduit for
rigged data to the largest insurers in the country. Cuomo’s
investigation found clear examples of the scheme: United insurers knew most simple doctor visits cost $200, but claimed to their members the typical rate was only $77. The insurers then applied the contractual reimbursement rate of 80%, covering only $62 for a $200 bill, and leaving the patient to cover the $138 balance.
NY Attorney General
Hillary Clinton Healthcare Taskforce Records Still Secret 2-10-08
Hillary Clinton has made healthcare reform a keystone of her campaign.
However the records from her first healthcare taskforce under Bill
Clinton's administration still remain secret.
Judicial Watch has filed a Freedom Of Information Act lawsuit to
get the government to release these records, which have become a
major issue for anyone wanting to objectively evaluate Hillary's
health plan. There are over 3 million records from her secret
taskforce which remain unreleased. The initial records which have
emerged have been cause for concern. “These documents paint a
disturbing picture of how Hillary Clinton and the Clinton
administration approached health care reform – secrecy, smears, and
the misuse of government computers to track private and political
information on citizens,” said
Judicial Watch President Tom Fitton. “There are millions more
documents that the Library has yet to release. The Clintons
continue to play games and pretend they have nothing to do with this
delay. The Clintons should get out of the way and authorize the
release of these records now.” In a recent editorial the
Washington Post has argued against the release of the Task force
documents before the November election.
Clinton, Obama, and McCain Healthcare Proposals Compared
at Forum 2-04-08
In a recent Washington DC forum
representatives for Clinton, Obama, and McCain discussed and
compared their healthcare policies. Each one tries to improve
coverage. McCain's proposal relies on tax credit incentives and the
free market. Obama would mandate coverage for children, but not
adults. Clinton mandates coverage for everyone and requires every
adult to purchase health insurance which would have income based
subsidies. The Wall Street Journal criticized the Clinton approach as
heavy handed, stating that it is "really a government mandate that
requires brute force plus huge subsidies to get anywhere near its
goal of universal coverage."
Health Reports. A comparison of different candidates healthcare
platforms is at
Insurers To Stop Paying For Hospital Errors 1-15-08
Aetna and Wellpoint will
ban payments to hospitals for serious medical errors. A list of
28 conditions for which insurers may ban payments includes items
such as surgery on the wrong body part or wrong patient, and
death or disability due to incorrect medication or blood
products as listed by the
National Quality Forum. Last October the federal Medicare
program announced that they will no longer pay for six
preventable conditions that arise as a result of
hospitalization, such as bed sores, falls, hospital-acquired
blood infections, blood clots in legs and lungs, and pneumonia
contracted from a ventilator.
Wall Street Journal
No Survival Benefit To Zetia 1-14-08
a recently released study, Merck and Schering jointly reported
that the cholesterol lowering drug Zetia did not improve
survival. Atheromatous plaques actually grew faster in patients
taking Zetia along with Zocor than in those taking Zocor alone.
Patients on Vytorin (Zocor and Zetia combination) actually had
more heart attacks, cardiovascular deaths, and heart procedures
than those who got Zocor. Those differences were not
statistically significant. Dr. Steven Nissen, the chairman of cardiology at the Cleveland Clinic, said
patients should not be prescribed Zetia unless all other
cholesterol drugs have failed. Analysts estimate that 70% of
Schering's earnings depend on these drugs.
- Doctors Get Six Month Reprieve From Pay Cut
Physicians will get a six-month reprieve from a 10 percent rate
cut when treating Medicare patients under legislation that
passed the Senate on 12/18/07. The pay cut for doctors had been
scheduled to take effect Jan. 1. Doctors had warned that a cut
in reimbursement rates would lead to physicians taking on fewer
new Medicare patients. Instead, they'll get a 0.5 percent raise.
- Federal Judge Rules That Data
Mining Firms Have Constitutional Right To Compile And Sell Prescription Info
A federal district court judge in Bangor ruled against a new Maine law
that would have made it easier for doctors to keep their prescription writing confidential. The law would have
attempted to restrict access to prescription information by companies that collect, analyze and sell medical data.
Pharmaceutical firms buy the data to help them develop marketing strategies.
Data mining companies said the law was unconstitutional and filed suit against the state in August.
In a decision issued 12/21/07 Judge John Woodcock said the law would prohibit "the transfer of truthful commercial information"
and "violate the free speech guarantee of the First Amendment."
There is no constitutional guarantee of a right to privacy.
Bangor Daily News.
In Washington, D.C., the local government is trying to restrict access to physicians' prescribing information,
but pharmaceutical companies are arguing that banning the practice is unconstitutional and could hinder research and efforts to monitor drug safety.
- Bush Administration Blocks Last
Minute Reprieve of 10.1% Medicare Pay Cut
Medicare part B expenditures, which includes physician payments, have increased faster than inflation. In order to achieve budget neutrality,
OMB initially sought cuts in payments to physicians. A 10.1% cut in physician Medicare fees was approved, scheduled to take effect
January 2008. The senate finance committee, headed by Max Baucus (D, Montana)decided to suspend these pay cuts for a year, and find alternative places to cut.
Predictably, every alternative source of cuts has lobbied congress to protect their turf. For example, the home
oxygen industry mounted a massive lobbying campaign
to block cuts. The Senate finance committee ultimately recommended cutting the Medicare
Advantage program. This is a notorious boondoggle
for the insurance industry. The Medicare Advantage program pays on average a 19% bonus to insurance companies over the
Medicare rates. The Bush administration has threatened to veto
any bill that fixes the physician pay cuts if it comes at the
expense of the Medicare Advantage program. Furthermore the Bush
administration has said that any fix for physician payments should
include a mandate for "adoption of certified electronic health information technology".
Physicians who don't use electronic health records or E-prescribing should be paid less, according to Health and Human Services secretary, Mike Leavitt.
- Zagat To Rate Doctors.
Wellpoint and Zagat are teaming up to rate doctors based on
Zagat's well known 30 point rating system.
WellPoint will begin to offer an online
survey using the Zagat approach to members in its Blue
Cross/Blue Shield subsidiaries in January 2008. The Zagat
restaurant rating system is based on food, service, decor,
and cost. Doctors will be rated based on availability, office
environment, communication, and trust.
- NJ Ruling Threatens Ambulatory Surgery Centers 12-13-07
Physician owned ambulatory surgical centers have been shown to
provide higher patient satisfaction and comparable outcomes to
surgery performed in hospital. A recent NJ ruling has concluded
that these centers violate the NJ State Codey law against self
referral. The Codey law prohibits physician referral to
facilities in which they have a financial self interest. It
exempts facilities that are part of a physicians office
practice, radiation oncology, kidney stone centers, and dialysis
centers. Hospitals have long sought to close down the
ambulatory surgical centers which they feel siphon off the best
insured patients, and thus compromise hospitals
Philadelphia Inquirer . Previously New Jersey's hospitals
persuaded the state Legislature to boost charity-care
funding by 53%, but the bounty came at least in part by a tax on
ambulatory surgical centers.
- Pilot Program Offers Incentives For EMR Implementation
Is Medicare tossing us a bone or a brick?
The Centers for Medicare and Medicaid Services announced a pilot project to give higher Medicare payments to
doctors who adopt electronic medical record systems, starting next summer. They want 1200 practices to
participate. The magnitude of the bonus hasn't been decided. The project will be revenue neutral, so ultimately
those of us who don't adapt EMR will be penalized. Implementation will be the first step,
the next step will be preparing reports on clinical quality measures, and the third step will be requiring us
to show how we are improving on clinical quality measures.
American Medical News
- Bipartisan Call For Electronic Prescriptions
The last time Kerry and Gingrich
agreed was back in Sept 2002, in support of the invasion of
In a joint editorial in the Wall Street Journal 11/16/07, John Kerry and Newt Gingrich lay out the case for
E-Prescriptions. They state that "If a majority of doctors don't e-prescribe a few years down the road, the government
should require all doctors to adopt e-prescribing or face financial penalties.
Their argument was undercut a few days later by Karl Williams,
an associate professor of pharmacy administration, who pointed
out in an 11/21/07 letter to the editor that by law many
prescriptions, such as controlled substances, may not be
transmitted electronically. As of 12/5/07 a senate bill has
already been introduced to mandate electronic prescriptions.
Senators have also called on the DEA to allow electronic
prescribing of controlled substances.