Government Elites at CMS Say Doctors Must Prescribe Electronically

Democrats are mad to define themselves as the party of top-down centralized planning. Moreover, if 15 Washington-based experts really can save a system as vast as Medicare through a process of top-down control, then this will be the only realm of human endeavor where that sort of engineering actually works.

David Brooks, “Where Wisdom Lives, “ New York Times, June 6, 2011

September 3, 2011 - There’s an unwritten understanding in Washington among the CMS power elite. It says: “We know more than doctors and patients about what is good for them. Wisdom resides here.”

CMS has decided that by January , 2012, doctors must prescribe electronically for bureaucratic clarity and safety of patients – no more scribbling on prescription pads, no more misunderstanding of illegible doctors handwriting, no more confusion about sound-alike drugs.

Besides, as a side benefit, electronic prescribing will give government the opportunity to track what doctors prescribe, and perhaps even control what they prescribe in the future.

Rationale

I understand the rationale behind this elitist thinking. So does David Brooks, technocrats in Washington, Brooks says, “tend to be skeptical that dispersed consumers can get enough information to make smart decisions. Health care is phenomenally complicated. Providers have much more information than consumers. Insurance companies are rapacious and are not in the business of optimizing care.”

The CMS decision therefore is for public power, public good – and public safety. In the process, it is also an example of further government intervention, with accompanying government limitations, into the affairs of doctors and their patients.

Limitations

CMS recognizes these limitations.

• The practice is located in a rural area without high speed Internet access.

• The practice is located in an area without sufficient available pharmacies for electronic prescribing.

• Registration is lagging for participating in the Medicare or Medicaid HER Incentive Program and Certifiable EHR Technology.

• Inability to electronically prescribe to due to local State, or Federal regulations.

• Limited prescribing activity.

• Insufficient opportunities to report the limitations of the measures denominator (whatever that means).

Otherwise

Otherwise Big Gov, and Big Brother, will penalize all of you prescribers by cutting 1% of Medicare payments starting January 1, 2012, 1.5% in 2013, and 2% in 2014.

Do not complain, you 110,000 doctors, nurse practitioners, and others who prescribe and who are estimated will not comply, or 60% to 80% of you who do not currently have EHRs.

Your alternative will be to cease seeing new Medicare or Medicaid patients or to drop out of third party arrangements, or install EHRs.

Remember, electronic prescribing is for your own good and the good of your patients. The handwriting is on the wall and on the fall. You will no longer be able to practice by the seat of your pants, but according to the seat of wisdom from Washington.

Tweet: Commencing January 1, 2012, physicians writing prescriptions will have to do so electronically or suffer a 1% cut in Medicare fees.