Proposed e-Rx Bonuses May Cut Pharmacy Dispensing Fees

Physicians may soon be entitled tocash bonuses for prescribing Medicaredrugs electronically, but pharmacists—not the federal government—couldwind up shouldering much of the costof those bonuses.

New legislation introduced by SenJohn Sununu (R, NH) would create "abudget-neutral financial incentive forthe rapid adoption of electronic prescribingunder the new Medicare prescriptiondrug program." Doctors whoabandon their prescription pads andprescribe drugs electronically for beneficiariesof the new Medicare prescriptiondrug program would be entitled toup to $1 for each e-prescription written.

The bonuses would be paid by pharmacybenefit managers and other prescriptiondrug plan (PDP) sponsors. Buta "dispensing fee offset reduction" provisionin the bill would allow PDPsponsors to recover much of the cost ofthose bonuses by reducing the dispensingfee for each nonelectronic prescriptionwritten by a physician. Under thebill, the bonuses and dispensing feereductions would remain in force fromthe onset of the new Medicare Rx benefit(January 1, 2006) until December31, 2009.

Mr. Rankin is a freelance medical writer.