Trade Group Says 50-State Patchwork Would Be More Expensive, Less Efficient

Washington, DC; 04.06.05 — For Medicare to realize the full cost-savings and quality-improvement potential associated with electronic prescribing in the new Medicare prescription drug benefit, Medicare should move quickly to adopt a program-wide, comprehensive system based on a uniform national standard that relies upon the most advanced technology working in the marketplace today, the Pharmaceutical Care Management Association (PCMA) announced today. PCMA is the national association representing America’s pharmacy benefit managers (PBMs).

PCMA made these recommendations as part of comments submitted late yesterday to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule for Medicare electronic prescribing (e-prescribing) standards. In the commercial marketplace, PBMs have pioneered the most advanced e-prescribing infrastructure and other health-information management tools to help employers, unions, health insurers, and others to improve outcomes, promote safety, and reduce costs.

“PCMA believes that Medicare e-prescribing holds the potential to transform the health care delivery system,” said PCMA President Mark Merritt. “Regrettably, a 50-state patchwork approach would increase costs, decrease efficiency, and severely undermine the promise of e-prescribing.”

In comments submitted to CMS, PCMA focused on these key areas in the proposed rule:

PCMA believes one national uniform standard is critical to making e-prescribing work for beneficiaries as Congress intended. Both the Medicare Modernization Act and the conference report make clear Congress’ intent that both Medicare e-prescribing and the commercial market should be subject to one national, uniform standard. A uniform national standard is essential to maximizing private plans’ participation in the part D benefit and in helping to reduce regional variations in health care delivery and outcomes.
PCMA believes that duplicative and conflicting state laws and regulations will increase costs and should be pre-empted by Medicare. PCMA has serious concerns that requiring part D participants to adhere to both Medicare standards and 50 separate state rules for e-prescribing would be an administrative nightmare and undermine quality. Moreover, without Medicare preemption of state e-prescribing laws, the cost of the drug benefit could soar as plans are prevented from leveraging fully proven cost-savings tools, including formulary compliance and therapeutic interchange.
PCMA believes that Medicare should rapidly adopt a comprehensive, program-wide e-prescribing system based on the most advanced technology working in the marketplace today. PBMs are at the forefront of utilizing advanced e-prescribing systems in the commercial marketplace today. Rather than experiment with unproven technology, PCMA believes that Medicare should rely upon the most advanced system working today for consumers and purchasers throughout the health care system.

Related Links:
PCMA Comments on E-Prescribing
Board of Pharmacy State E-Prescribing Survey

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The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmacy benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614