Medicare Compliance & Reimbursement

Plus: What health plans, providers can do to reduce Medicare costs.

Insurers have long touted e-prescribing as a promising development, but many providers have been slow to adopt the comprehensive--and often expensive--technology. Now these excuses may no longer hold water.

The National ePrescribing Patient Safety Initiative (NEPSI), which clinical technology provider Allscripts and computer giant Dell have spearheaded, rolled out a new program, "eRx NOW." This software is available for free to "any healthcare provider with legal authority to prescribe medications, and requires no download, no new hardware and minimal training," according to a NEPSI statement.

The challenge is to increase the number of physicians who currently process prescriptions electronically--a number that now stands at fewer than one in five, according to one study from the eHealth Initiative. The push could well be successful, judging from the slate of technology companies that have sponsored NEPSI: Cisco Systems, Fujitsu Computers, Google, Microsoft, Sprint, and SureScripts, among others.

And insurers are also signing on. Both Aetna and WellPoint are on board, as well as large regional entities like Horizon Blue Cross Blue Shield of New Jersey. Managed care organizations like these believe that widespread adoption of e-prescribing will decrease errors and thus reduce health-care costs.

And that might be the start of something even more attractive to insurers. NEPSI could also represent "an on-ramp to a complete Electronic Health Record," enthuses Allscripts CEO Glen Tullman.

Read more about NEPSI at www.nationalerx.com.

Benes With Vision Problems Have More Health Issues

Want to see Medicare costs go down? One answer might be to facilitate more effective treatment for benes who have vision problems.

Older people with poor vision had higher medical costs than sighted people, and 90 percent of those costs were non-vision related, found a study sponsored by the American Academy of Ophthalmology (AAO) and performed by the Potomac Institute for Policy Studies, the Wilmer Eye Institute at Johns Hopkins University and Pfizer.

The team looked at 1.5 million Medicare beneficiaries continuously enrolled from 1999 to 2003 and found that people with moderate, severe and total vision loss were more depressed, sustained more injuries and needed more nursing-home care than did people with full sight. The bill for these non-vision related problems came to $2.14 billion in 2003.

The AAO is encouraging the Medicare program to add general vision assessments at Medicare entry to its eye-health roster, which already includes annual glaucoma screenings for patients at risk, plus eye exams for diabetics.

In Other News...

• Carriers mistakenly listed the professional-component relative value units (RVUs) for new tissue ablation codes 77013 and 77022 as zero, according to the Physician Regulatory Issues Team (PRIT). Medicare should soon issue a correction notice with the corrected RVUs.