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E-Prescribing is a Must

October 16th, 2012  |  The Blog

A true electronic prescription (e-script) is one that is submitted directly from the prescriber’s computer to the pharmacy’s computer (e-prescribing). Faxing a prescription to the pharmacy does not count as e-prescribing; neither does handing a computer-generated, printed prescription to the patient.

E-prescribing is a fact of life, not an option, in the current U.S. healthcare system. For a physician: write a prescription on a traditional paper prescription pad and suffer the consequences. When it comes to payment, Medicare will penalize physicians who choose not to e-prescribe.

Why is E-prescribing So Important?

The most important aspect of e-prescribing is increased patient safety. The next benefit covers increased patient compliance with actually filling the prescription.

Three billion prescriptions are written every year in the U.S. With that figure in mind, there are an estimated 7,000 deaths annually that are attributed to medication errors. Illegible writing, incorrect dosing and drug interactions account for the majority of medication errors. E-prescribing can eliminate such life-threatening errors.

E-prescribing verifies correct medication names, appropriate dosing and interactions between current drugs taken by the patient. Patient safety is paramount. Time efficiency is dramatically enhanced with the majority of telephone calls from a physician’s office to the pharmacy being virtually eliminated.

Prescription Compliance

Prescription for antibiotics, asthma and allergy drugs and dermatologic agents have the highest compliance for being filled in a timely manner. Nutritional supplements for pediatric patients are filled the least often, according to a recent study published in Pediatrics.

One study reports that 20 percent of traditional paper prescriptions are never filled. For the consumer, aka patient, e-prescribing is a major safety net. It also, according to recent studies, increases prescription-filling compliance. Paper prescriptions are historically filled within a week of being written while e-scripts are filled within a day. This is especially true with prescriptions for the pediatric population.

The Penalty

In 2012, the Centers for Medicare and Medicaid Services (CMS) reduced physician reimbursement by 1 percent for those doctors who did not e-prescribe at least 10 times during the first half of 2011. The penalty will increase to 1.5 percent in 2013 and upward to 2 percent in 2014 for those physicians who do not comply with the mandate to e-prescribe. The CMS does not call non-compliance a penalty; they refer to the program as a downward adjustment. There is no bonus for complying with the requirements. This practice is an expectation, not an option.

Successful e-scribers, according to CMS, are exempt from penalty in a given year. For example, a successful e-scriber in 2011 is exempt from penalty in 2013 while compliance in 2012 allows for exemption in 2014.


There are exemptions for a limited number of medical professionals. Practicing in a rural setting with limited high-speed Internet access constitutes an exemption from e-prescribing for physicians. If a physician plans to file for an exemption, it must be done via the CMS website. The initial deadline was June 30, 2012.


There is a wealth of information on various medical websites about how to become an e-prescriber.

For the most comprehensive information, including how-to’s, bonuses and exemptions, refer to the CMS website: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ERxIncentive/index.html.




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