HHS’s Leavitt Issues Progress Report on E-Prescribing

       In a recent report released to Congress, Department of Health and Human Services (HHS) Secretary Michael Leavitt announced the results of an electronic prescribing (e-prescribing) pilot project that support the adoption of new standards. These e-prescribing standards, required by the Medicare Modernization Act of 2003, would help cut both medication errors and healthcare costs.
       “Electronic prescribing improves efficiencies while helping to eliminate potentially harmful drug interactions and other medication problems,” says Leavitt. “It also solves the problem of hard-to-read handwritten prescriptions. Additionally, such health information technologies promote affordability by allowing physicians to know which medications are covered by their patients’ Part D plans.”
       The pilot project demonstrated that three initial standards are already capable of supporting e-prescribing transactions in Medicare Part D. Some of the initial e-prescribing standards tested by the pilot project were found to have potential but still need development if they are to be adopted as e-prescribing standards. These include standards used to convey structured patient instructions, a terminology to describe clinical drugs, and messages that convey prior authorization information.
       For a copy of the report, visit http://healthit.ahrq.gov/erxpilots.

CMS Announces Contingency Plan for Covered Entities

       The Centers for Medicare & Medicaid Services (CMS) announces it is implementing a contingency plan for covered entities (other than small health plans) who will not meet the May 23, 2007, deadline for compliance with the National Provider Identifier (NPI) regulations under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
       The final rule establishing the NPI as the standard unique health provider identifier for healthcare providers requires all covered entities to comply with its provisions by May 23, 2007, except for small health plans, which must be in compliance by May 23, 2008.
       The NPI is an identifier that will be used by covered entities to identify healthcare providers, eliminating the current need for multiple identifiers for the same provider. The NPI replaces all “legacy” identifiers that are currently being used, such as Medicaid provider IDs and individual plan provider IDs, and will be required for use on healthcare claims and other HIPAA transactions.
       CMS encourages health plans to assess the readiness of their provider communities to determine the need to implement contingency plans to maintain the flow of payments while continuing to work toward compliance. It also encourages providers that have not yet obtained NPIs to do so immediately and to use them in HIPAA transactions as soon as possible.
       For more information and/or to apply for a free NPI, visit https://nppes.cms.hhs.gov.

AHCA/NCAL Praises Effort to Eliminate Part D Co-Pays for Dual Eligibles

       The American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) praise Senator Gordon Smith (R-Ore) and his co-sponsors for their introduction of the Home and Community Services Co-Payment Equity Act of 2007. This legislation would provide dual eligibles (those eligible for Medicare and Medicaid) living in assisted living residences and other home- and community-based settings the same co-pay coverage under Medicare Part D as those residing in nursing facilities.
       “Our residents require the same number of medications as nursing facility residents, yet this group of low-income assisted living residents is unable to afford its co-payments and therefore is denied access to life-saving medicines,” says David Kyllo, Executive Director of NCAL.
       According to research, dual-eligible assisted living residents take 8–10 medications, and with Part D drug co-pays ranging from one to five dollars, their expenditures can quickly exceed the monthly personal allowance under Medicaid. And as more states opt to use Medicaid to cover assisted living services, this population of beneficiaries is expected to increase.