Health IT
I’m returning from Chicago where we had a meeting of the American Health Information Community. This is the Federal Advisory Committee HHS initiated to advise the Secretary on health information technology standards. I won’t report on the meeting. We Web cast it and it’s available on the HHS Web site if you’re interested (http://www.hhs.gov/healthit/community/meetings/m20071113.html). I do want to reflect on a subject the meeting caused me to begin thinking more about.
We had a discussion about electronic prescribing of medicine. The technology necessary to electronically receive and fill prescriptions exists in most pharmacies in the United States. However, only a small percentage of doctors use it. The benefits are unchallengeable. E-prescribing is not only more efficient and convenient for consumers, but widespread use would eliminate thousands of medication errors every year. At the AHIC meeting, we announced standards that will help to get us there. We are starting with standards for providing medication history and for formularies so that providers have the information they need to write correct prescriptions. These two standards alone could go a long way to eliminating errors.
Most doctors haven’t invested in the necessary technology to do e-prescribing. The reasons are complex and range from a perceived lack of financial incentives to a reluctance to give up the familiar prescription pad. It is not expensive. This change needs to happen and, from my standpoint, sooner rather than later.
The last several years we have been nudging the medical family toward this. This fall, we eliminated the capacity for providers who have an e-prescribing tool to fax prescriptions paid for by Medicare to pharmacies. That has motivated some to use electronic systems. However, we need to do more, I think, including using our power as a payer to motivate the change.
When I was Governor of Utah, I spent time with members of the Highway Patrol. I discovered that after a drunk driver was ticketed it took the patrolman nearly three hours to fill out a stack of forms that was a quarter-inch thick. They then made four copies of the stack and mailed them to various parts of the government for processing.
I ordered laptops installed in patrol cars and had an electronic system developed that allowed users to process documentation in a fraction of the time. The system had undeniable benefits of efficiency and safety because patrolmen could spend more time on the road and less time in the office doing paperwork.
There was a problem I hadn’t considered. Many of the officers didn’t keyboard and frankly some of them were resistant to learning. Ultimately, I had to say, “Look, we are at a point where we can’t afford to have people on the highway patrol who can’t type. If you want to work here, you need to develop the skill to fill your reports out efficiently using a computer. We’ll help you learn, but this is now a requirement of your job.” The patrolmen that didn’t have the skills developed them and the system functions well.
E-prescribing needs faster implementation. We have been through all the public processes necessary to develop standards. The technology is readily available and widely distributed. Electronic prescribing will enhance the safety and convenience for patients. Large health care providers, including Medicare and Medicaid, need to move toward making it a mandatory part of medical practice soon.
Posted on November 16, 2007 in Health IT
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Dr Leavitt,
Your example about the patrolmen should be enough to push e-prescriptions along.
Many drugstores already use computers for filling and scheduling refills.
I fear a break down in the system. I fear a lack of back-up systems. I would like to see those two points addressed not only on a daily basis but an emergency one like a Pandemic.
My personal experience has been with my child and Daytona. It is not widely used so finding to fill a prescription is hard. Because it is schedule 2 the pharmacy must have enough on hand. They do not want to move this drug between stores.
I hope e-prescriptions could help with that paperwork as well.
Regards,
Posted by: Allen | November 16, 2007 at 05:56 PMAllen
While not directly related to your post about E-prescribing, have you seen Microsoft's HealthVault(http://www.healthvault.com/) or heard of Google's planned system?
(I believe that Microsoft's system could be used by doctors and pharmacies to exchange prescriptions, though it's main purpose is health information storage.)
Both are great ideas on the surface, but issue of transferability of data from one system to another is critical. I hope that the titans at work on this can come up with a reasonable standard that allows consumers to decide where to store their personal data.
Posted by: Jeff Lewis | November 16, 2007 at 06:08 PMYour blog on e-prescriptions is very timely. I'm working in the Medi-Cal Managed Care division of DHS in Sacramento, but have no idea what the current status in California is on this procedure. We like to think of this state as a trendsetter in technology, so this is worth investigating. You probably have data from our department, but I will do some research on this for my own understanding. I'll forward any breaking news, may be good for our state's image.
Posted by: Jonathan | November 16, 2007 at 07:40 PMDear Jonathan,
You make an interesting point in saying " I'll forward any breaking news, may be good for our state's image. "
California has bought multiple mobiile hospitals. Yes the military has them but they already have a full time job. In buying their own the state says "we can take care of our people before burdening FEMA, the government or others."
I do hope the E-prescrioption goes through if and only if it is helpful, better and has a *working* backup system.
To me it seems like a great idea. Sigh, but anything can look like a great idea by glossing over problems. It is being able to acknolege and deal with problems that count.
Regards,
Allen
"Information is inversly propotional to the glossyness of the brochure" - Allen
Posted by: Allen | November 19, 2007 at 08:26 AMSecretary Leavitt - I applaud CMS move to ePrescribing. The technology is a win/win/win for everyone, both in terms of cost savings and patient safety. One of the issues I think that needs to be addressed is the participation of the malpractice insurance firms. A discount on these rates could be justified if the eRx results in a measurable prevention of medication errors. That would provide a strong financial incentive for physician adoption.
There is some good data coming out of Massachusetts in the days ahead. Please have someone contact me if you want more detail.
Marty Jensen
Posted by: Martin Jensen | November 20, 2007 at 10:45 AMHappy thanksgiving to all.
Though I find it weird that such an overweight well feed country would devote a day to stuffing ourselves even more there is so much to give thanks for.
Free speach, travel, security, health and now the ability to inteact with parts of the federal government - something our parents did not have.
Regards,
Posted by: Allen | November 21, 2007 at 12:18 PMAllen
"With all the new computers, cameras and laws may you have more peace, security, liberty and privacy than our founding forefathers could have imagined. If you have those, happyness can follow. Without them, it can not" - me
I'd like to state for the record that I agree with and support everything Mr. Leavitt wrote here.
Michael McBride
Editor-in-Chief
Health Management Technology Magazine
www.healthmgttech.com
Posted by: Michael McBride, Editor-in-Chief, Health Management Technology Magazine | November 21, 2007 at 02:13 PMAs a practicing physician and as CMO of a EHR software company, I can say that ePrescribing is a great idea, but it will not happen soon.
The software and ePrecribing Hubs are difficult to implement and costly for the physician. It offers no real benefit to the prescriber (prescriptions can be faxed at this time for little cost; our software does drug interactions/allergy checking already).
Most of us have had to spend thousands of dollars (8 thousand for my office) upgrading our software to accomodate the new NPI number and we are not in any mood to spend more time and money on another government project.
You need to present a case to show how ePrescribing will benefit prescribers if you want us to move forward on a costly and time consuming project. Or you need to present data that ePrescribing will benefit patients over current software that does durg interactions/allergy checking/fax transmission.
ePrescribing will not happen just because we think it will be a cool thing.
Posted by: Stephen C Fischer MD | November 21, 2007 at 03:50 PMDear Secretary Michael Leavitt:
I am relieved that you opened healthcare IT to debate. The issue screams for transparency. You show courage as well as confidence, Sir.
The responses to your blog about e-prescribing indicate that most stakeholders, including you, Mr. Leavitt, still fail to understand doctors. Stakeholders know them as “providers” and they call CMS the “payer.” You should be flattered because with your encouragement stakeholders proportion their respect accordingly. You enjoy tremendous influence, yet you mislead. And stakeholders adjust their product lines according to your every word, rather than doctors’ needs - a more logical marketplace.
There is no doubt that the majority of physicians’ practices in the nation could benefit from interoperable electronic medical records. However, physicians are not buying and nothing is interconnecting. While at the same time, patients’ identities are increasingly fumbled by the millions - bleeding out the nation’s confidence in your plans. If the public does not trust EMRs, and are not given the right to opt-out, the interoperable records will be more dangerous than no records at all, leading to thousands of family disasters across the nation. What is more, trust in HHS will be gone forever.
This is obviously frustrating for you as well as for impatient stakeholders with products on their shelves - products whose sale depends on mandate because the vendors’ asking price is too far above market value. How can this plan possibly cut national healthcare costs?
With all due respect to a US Cabinet Secretary, Mr. Leavitt, you have what appears to be an insurmountable problem ahead that cannot be bulldozed out of the way using CMS - which you repeatedly remind us, is the most powerful stakeholder in the nation. Even industry-supported dictators are unwelcome in the land of the free. Physicians may be incredibly preoccupied with their day-to-day responsibilities, but they are not foolish.
By my calculations, you have assembled five comments in favor of e-prescribing, while only one contributor, Dr. Stephen Fischer, the only physician in the group, has significant reservations about e-prescriptions. There is more: Dr. Fischer is the CMO of an EHR software company. He is not naïve. You knew this, of course, before you allowed his comments to be posted. You could have just as easily hit the delete button. I salute your courage, Mr. Leavitt, in the face of dissent. Here comes more.
While you are proud to eliminate prescriptions by fax, Dr. Fischer complains that this is a costly mistake. He writes, “The software and ePrescribing Hubs are difficult to implement and costly for the physician. It offers no real benefit to the prescriber (prescriptions can be faxed at this time for little cost; our software does drug interactions/allergy checking already).”
Among the five authors in favor of e-prescriptions are two well-known and respected authorities in the healthcare IT industry, Marty Jensen and Michael McBride. Mr. Jensen assures us that compared to Dr. Fischer’s fax machine, e-prescribing will indeed save money and provide patient safety, while Mr. McBride simply approves everything you say.
Like telephone conversations, fax transmissions are so secure that they are not even covered by HIPAA. Why does that bother stakeholders more than physicians and patients?
If US healthcare were a democratic institution equally representing the millions of HIPAA-empowered stakeholders who never learn patients’ names, interoperable EMRs would win in a landslide - majority rules. Now, imagine healthcare by polls for a moment, if you dare. The successful adoption of e-prescribing by physicians cannot be accomplished by stakeholders’ votes, regardless of their knowledge, enthusiasm and political investment.
Neither can adoption be successfully mandated. In the third paragraph, you write that doctors have not invested in the necessary technology because of the “perceived” lack of financial incentives. You promise us that healthcare IT is not expensive, yet you divert healthcare dollars to pay millions to 1200 physicians across the nation, just to try EMRs. The money could have been spent saving lives. I hope the sacrifice of elderly and poor Americans is worth it.
I am of the opinion that when physicians want EMRs, they will buy them. That is the way the free market works in the land of the free. Of all the people involved in modern healthcare, one can generally trust doctors. Every day people trust them with their lives to make sound decisions. We have to.
This brings me to a word of advice: You should never say to a bunch of doctors: “However, we need to do more, I think, including using our power as a payer to motivate the change.”
Statements like this cause physicians to no longer encourage their children to follow them in the healing arts. Where will my grandchildren find talented doctors if my nation’s Secretary of Health and Human Services shows such a lack of respect for the profession?
Sincerely, Darrell Pruitt
cc: spamgroup
Posted by: Darrell Pruitt | November 22, 2007 at 05:46 PMI take issue with your assertion that pharmacies already have the technology for e-prescribing but physicians won't use it.
- there isn't one pharmacy in our area prepared to allow physician to send an EDT prescription. Their information systems are for their own use, only.
- if there were a web site on which we could log in, there would be a different one for each pharmacy chain and local pharmacy, each with its own password, which, according to current IT standards, would need to be changed every 90 days or so to remain secure.
Before I became the Hospice Medical Director full-time, my practice had a well-done EMR that had all the decision support for prescribing, but we were left with printing those prescriptions and handing them to the patient or faxing them to the pharmacy, because none of the local pharmacies were prepared to receive it directly, including Walgreens, Sam's Club, CVS, OSCO, and Meijer.
In addition, each of these pharmacies uses its own software, with its own data standards.
To make e-prescribing truly the benefit you describe (and I agree with the potential for those benefits), prescribers need a single sign-on interface whose data standards are available to EMR vendors and from which the user can select participating pharmacies to which the prescriptions can be transmitted.
The issue is, however, larger than e-prescribing alone. It includes the entirety of electronic medical record-keeping. Physician prescribing, medical records, and patient personal health records will not be useful until they are interoperable, and they will not be interoperable until they all call the same thing the same thing. Right now, because of the lack of data standards, interfacing one piece of software with another is an expensive, time-consuming process which requires ongoing maintenance. Waiting for vendors to agree to a data standard is a fairy tale, because the last thing they want is for one of their clients to be able to move data to different software. There are, unfortunately, marginal products which remain in business only because the spectre of changing to different software, with the associated loss of data or need for manual replacement of data is so frightening that the users prefer to put up with the inadequacies of the software. If we are to achieve truly interoperable systems, they will need to all call the same thing the same thing, and it is likely that that will need to be imposed from without.
Several years ago, Medicare wearied of trying to figure out what lab tests were in a CHEM7 as opposed to a SMAC6 (etc., etc.) and said "...we will only pay for the following panels which contain the following tests..." and now everyone in the country knows what to expect to find in a basic metabolic panel, a comprehensive metabolic panel, a renal disease panel, and so forth. Perhaps it is time to say to the Health Care IT community "...you have a year. Either you come up with the standard, or we at Health and Human Services will, and then you will all have to change to it..."
Posted by: David Tribble, MD ABHPM FAAFP | November 23, 2007 at 11:18 AMI am a physician in private practice and I have the skills necessary for e-prescribing and using an EMR, and I am all for it. However, I disagree with your approach to this and believe you are not being consistent. Did you have the police officers personally buy the laptops and software needed?
Posted by: Zbigniew Woznica, MD | November 30, 2007 at 10:54 PMInstead of mandating that physicians do this, wouldn't a better approach be to provide the infrastructure for the physicians to do this? I believe a cooperative role with physicians in caring for our patients would be preferable.
E prescribing comments: Patients should have freedom of choice of where to fill their prescriptions. I realize their insurance plan may have certain restrictions.
Posted by: Cathy Thrasher | December 03, 2007 at 04:39 PMTHe doctor eprescribes. The prescription needs to linked to the pharmacy. Currently, there are at least 3 vendors trying to capture this business. My understanding of one vendor operation is that if pharmacy has not contracted with the switching vendor, the vendor will fax. I also have been informed the pharmacy is charged a fee for the privilege of receiving the prescription. The doctor is not charged but the pharmacy is. Will this be covered by Medicaid if it is a Medicaid prescription? Does the patient pay out of pocket? We do not want to have pharmacy become just 2 or 3 chains that are concentrated in populous areas.
There are many concerns and details that need to be worked out.
It is very shameful and quite alarming that the Secretary of HHS threatens physicians with the might of the CMS.
After having tired to get e-prescribing via my fully functional EMR for over 2 years I am still waiting for it to go live. If a fully willing and able physician practice has this problem just establishing E-Rx program, how does the Secretary believe less equipped physicians will take to e-prescribing? Force has never worked and will never work in a free society. Unfortunately, more Medicare patients will have less physicians to take care them if this type of force is applied (instead of a cooperative effort) in bringing e-prescribing to daily use. The secretary's efforts will pay off better if he uses his position to effectively nudge the monopolists to share their software so that unnecessary roadblocks are removed in the path to e-prescribing. Again, I wonder how many police officers in Utah purchased their laptops and how many of them actually installed them in their cars. That question (posed earlier) has not been answered...
Posted by: A Cavale | December 03, 2007 at 10:33 PMAs the head of an EMR software provider, I appreciate your comments on e-prescribing. As a patient, however, I see a major weakness in the e-prescribing system as you envision it; that being the prescription being tied to the particular pharmacy to which it was electronically sent.
The advantage of a paper-based prescription (which can be produced and printed from an EMR, eliminating handwriting issues) is that I, as the patient, can take it to whichever pharmacy suits my needs at the time I want the prescription filled. If the pharmacy I usually go to is closed for the night (or, worse, has had some disaster befall it), I can take a paper prescription to the pharmacy up the street that's still open. This issue must, I feel, be addressed before e-prescribing is mandated by law.
Sincerely,
Posted by: Bill Horvath | December 05, 2007 at 10:06 AMBill Horvath, CXO
DoX Systems
Dear Secretary Leavitt:
Why push a technology onto physicians by tieing it into their already low Medicare payments? Do you want to force them to opt out and destroy their practices?
Problems that I see with e-Prescribing from what I've read include:
--Physicians are made to again pay for a good deal of the technology together with pharmacists. Patients and insurance companies, those entities that benefit most, pay NOTHING.
--You want to replace the current PAPER and FAXING of prescriptions both of which still work well and are FREE with a $300 to $500 a year per license cost (not including the EHR cost), making it another unfunded mandate.
--30% of retail pharmacies do not have e-prescribing capabilities.
--The DEA has a ban on e-prescribing for controlled substances, which account for 11-13% of all prescriptions. In addition, some states have paper-based requirements for narcotics prescriptions.
--It takes approximately 6-12 months for a vendor to become certified in SureScripts, the most prominent company associated with e-prescribing. This expensive developmental cost, with is part of the CCHIT certification process, invariably is passed on to the physician consumer in the higher EMR prices.
--Many of my fellow docs lament the problem of having to carry a tablet PC or laptop with them to prescribe.
--Lastly, many patients, especially the elderly, prefer paper prescriptions which in the current bills before Congress may signify penalties to the provider.
I truly hope that Congress ignores your request, which is misguided.
If you wish, you can download my 65 page Powerpoint report on HIT called: "What Has Gone Wrong with the Direction of the Health Information Technology in the United States?" from here: http://www.emrupdate.com/files/folders/al_borges/default.aspx?PageIndex=2.
It makes for a good read. It covers CCHIT, P4P, and e-Prescribing from a physician's point of view and it offers suggestions on how to improve the HIT by taking a different path.
Sincerely,
Posted by: Alberto Borges, MD | December 12, 2007 at 05:21 AMAl Borges MD
Dear Secretary Leavitt,
I have always pictured the role of government to protect the rights and liberties of its citizens. In the case of pushing for unfunded mandates such as e-prescribing, and CCHIT, the government is using its power to eliminate small solo-physician practices like mine.
Posted by: Roy E. Gondo, MD | December 12, 2007 at 12:59 PMIn our community, large entities such as corporate owned hospital and FQHCs have virtually decimated the private practice of medicine. E-prescribing companies by virtue of technological and marketing resources required are limited to a few companies (Allscript and Surescript). This is basically government endorsement of these companies. These entities will continue to suck whatever revenue that we hard working independent physicians are able to make with the restrictive anti-competitive policies that the US government has placed on small practices.
CCHIT will force limitation of choice of EMR to a few high priced (unaffordable to small practices running on thin margin).
Dear Secretary Leavitt:
I am not a highway patrolman, and I don't work for you.
I am a private physician who is working harder and harder just to make ends meet. I have cut overhead as low as I can and I am looking at creative ways to limit expenses, let alone give raises to my valued employees.
I have already had to cap my Medicaid patients, in order to keep my cash flow from further dwindling.
I, therefore, get to feeling extremely resentful when someone hands me an unfunded mandate from on high, and tells me "Son, if you want to work here (America) from now on, you'll have to pony up some extra cash, and do it *my* way."
Posted by: James Brian Cotner, M.D. | December 12, 2007 at 02:04 PMDear Secretary Mr. Leavitt:
I am glad you have this blog asking for public input.
There is no proof that CCHIT certification is scientifically superior to non CCHIT certified EMRs in providing better care to the US population. CCHIT has been a self proclaimed, pop up agency, which is trying to promote itself with no basis. If you or your staff know of a study which compares certified EMRS to a "control group" of Non certified EMRs to show who is providing better care please enlighten us.
Many of us Physicians had EMRs from time before CCHIT came into existence. Now forcing us to switch to a expensive CCHIT EMR for no reason is a draconian measure from powers would be.
I wish you a Merry Christmas and a happy new year.
Best Regards.
Posted by: Joseph | December 13, 2007 at 06:45 AMDear Secretary Leavitt:
I re-read my earlier post today, and I sounded pretty hacked-off, which I was at the time.
I do appreciate you giving us the opportunity to comment on these issues. However, the seeming arrogance of your post offended me.
In your mind, hundreds of thousands of professional men and women, entrepeneurs, business owners large and small would seem to be analogous to:
Employees of the State?
A squad of public servants that you can command at will?
Cops who can't type, and don't want to learn?
Hidebound obstacles to good health care?
You get the point.
Anyway, I think that before you put your "power as a payer" behind e-prescribing, you need to spend a little more time talking with physicians that use those systems, about their "complex reasons" for not using these systems.
Most of the doctors I talk to are not happy with the e-prescribing systems they have used, and prefer to e-fax their prescriptions to the pharmacy themselves, directly. They lament the added expense and decreased patient privacy that is involved in working with a third-party e-prescribing company. Instead, they are shopping for EMRs that allow direct faxing to the pharmacy *without* the middle-man.
Physicians want to practice good medicine, and they don't want to make medication errors. If you think your program helps physicians to do those things, but physicians aren't buying into it, you need to take another look at your program.
I will say that your blog was thought-provoking, and I enjoyed reading many of the responses. Once again, thank you for giving us the opportunity to disagree with you in this public forum.
Posted by: James Brian Cotner, M.D. | December 13, 2007 at 10:49 PMPhysicians have had no real increase in reimbursement from Medicare over the last 5 or so years. Disregarding the looming 10.1% cut in reimbursement by Medicare, where is the money to come from for my purchase of the "not expensive" e-prescribing system?
If the CMS wants us to e-prescribe, they should develop the software (perhaps for a system using the Internet) and provide it free of charge to each physician who has an NPI. If it is not-expensive for me to purchase, then the cost should negligible for CMS.
It is not fair or reasonable to ask me to purchase a new system for NO REASON. In the last 10 years since I went into private practice, I have had ZERO prescription errors for my patients that were the result of my written prescriptions or faxed prescription renewals.
I seriously doubt the statistics that are being quoted for the number of prescription errors nationwide. Please explain why I should not regard these inflated statistics as a "straw man" excuse to designed to increase profits for software and hardware manufacturers?
Thank you for the opportunity to ask questions and propose rational alternatives to the unworkable plans that are afoot.
Posted by: L Mallette, MD, PhD | December 15, 2007 at 10:16 PMDear Secretary Leavitt,
Posted by: Dr. David Gloor MD | December 17, 2007 at 04:52 PMAfter reading the article in our AMA news and some of the above comments I feel compelled to add my thoughts. I've long been extremely sceptical of the numbers and statistics thrown around regarding medical errors and especially the cost savings involved. This AMA article quotes $29 billion in savings in 2010. If that is even remotely accurate, then there should be more than enough revenue to pay for EMR systems in all our office as well as repealing the 10.1% Medicare cut on the horizon. As it is, however, no one wants to pay for or reimburse me for purchasing an EMR system that saves me nothing. Even though you state these cost very little, the reality is most syetems cost $20,000-50,000 per provider and most are not compatable with each other. The analogy would be requiring your police officers to purchase their own laptop systems and docking their pay if they refused. These saving dollars get thrown around like absolute truth when those of us in the business can't see even a fraction of what's quoted. It is the health insurance and pharmacy industries that may save money with this, they should shoulder the costs.
Sincerely,
David Gloor M.D.
Subject/Question - Why must the Government require the SSN on our medicare cards?
A simple IT change similar to what Virginia State did years ago with our drivers licenses could be readily implemented.
As one grows frail in latter life, we now have to carry teh most important personal identification in our handbags/walets. Just ready for some thug to run off with it.
Issue cards with a random number only used by medicare, you / Medicare does not need me to carry a card with SSN on it, just an identifier Medicare and I both agree to use.
AND Stop the status reporting contractor from putting the SSN on all correspondance. It serves no purpose. I know who I am. And it is sent to my address. If I do not get it, the SSN would not help me and only help someone to steal my identification.
Below is email to medicare omsbudsman office re subject
Subject
Why must this government department insist that the SSN be on teh medicare ca...
Discussion Thread
Response (Eric) 12/20/2007 03:17 PM
Thank you for visiting www.medicare.gov. This is in reply to your question regarding your Social Security Number on your Medicare card.
I apologize for any inconvenience having your Social Security Number on your Medicare card has caused. At this time there is no information regarding changing the Medicare card.
Since many aspects of the Medicare Program are added through federal laws, you may want to share your ideas on changes to the Medicare Program with your U.S. Congressperson. They can be reached by telephone or mail. You can visit http://www.firstgov.gov to obtain your Representative's or Senator's contact information (names, addresses, telephone numbers), or check the government pages of your local telephone directory.
I hope this information proves helpful.
Customer 12/19/2007 08:11 PM
I expected much more from my Government than the the GS 3 level response I received.
ONE - The response is a simple restatement of what the medicare beauracy / Government currently does. The existing POLICY. The response does not acknowledge that I have asked a question and does not answer the question. Does not recognize that I have identified an actual problem, does not provide reasons to continue the current problematic approach, does not indicate reasons medicare can not incorporate the approach that the State of Virginia adopted many years ago with their drivers licenses.
TWO - The response again goes on at length to tell me to protect the medicare card because it has my SSN on it. I KNOW THIS FACT and THAT IS THE PROBLEM I AM RAISING and want corrected. Get rid of the SSN on the card. Please re-read the question...>
Response (Keely) 12/16/2007 12:13 PM
Thank you for visiting www.medicare.gov. This is in reply to your question regarding changing your Medicare card number.
I apologize for the inconvenience; however, Medicare card numbers are Social Security numbers followed by a letter.
After you enroll in Medicare, you will get a red, white, and blue Medicare card. It has your name, Medicare number, sex, a place for your signature, and the dates your Part A and Part B coverage began.
Generally, your Medicare number is your or your spouse's Social Security number followed by a letter. Be very careful with your Medicare card and always keep it in a safe place. Never let anyone else use your Medicare card. Your Medicare number is also included on your Medicare Summary Notices.
Identity theft is a serious crime. Identity theft occurs when someone uses your Medicare number and/or personal information without your permission to commit fraud, incur medical expenses, get medical care in your name, or other crimes. Personal information includes the following:
• Name
• Social Security number
• Credit card number
• Medicare number
• Other identifying information
However, there are steps you can take to help protect yourself from this form of identity theft:
• Protect your Medicare number. Give this personal information only to doctors or other health care providers, and only when needed.
• Protect your Medicare number as if it was your credit card.
• If you are going to throw Medicare documents away, remember to shred them first.
• Do not give out your Medicare information over the telephone unless you have requested assistance from the Medicare program.
• Remember to review your Medicare Summary Notices for accuracy.
• You can access your current Medicare account 24 hours a day by visiting www.MyMedicare.gov.
• Review your Part D Explanation of Benefits to make sure only prescriptions you filled are on the statement.
You may also choose to write "See ID" instead of your signature. Your health care provider will ask you for a picture ID to make sure you are the cardholder.
If someone is using your Social Security number, you should file a complaint with the Federal Trade Commission. You can do this on the internet at http://www.consumer.gov/idtheft or by calling 1-877-438-4338 (TTY 202-326-2502).
If you have filed a complaint and you feel that someone is still using your number, the Social Security Administration (SSA) may assign you a new number.
The Social Security Administration issues Medicare cards and assigns Medicare numbers. Please contact them for more information. You may call 1-800-772-1213, between 7 am to 7 pm, Monday-Friday, or visit your local Social Security office. For the office closest to you, try the field office locator at http://www.socialsecurity.gov/locator.
I hope this information proves helpful.
Customer 12/12/2007 03:32 PM
Why must this government department insist that the SSN be on teh medicare cards and on each status report sent to my home address?
The state of Virginia went to a random (not SSN) number on the drivers license. Why can the Federal Govt do same?
You all continue to tell us to protect our identity and be very care full of possible theft. But then the Gov't makes us (frail, some what mentally challenged) carry a medicare card with the MUST IMPORTANT information ever; just waiting to have the purse stollen! Or have someone open our letters and copy it from the status reports. WHY??
ONE: - Issue medicare cards with out the SSN, use a random number or password.
TWO - Get the support contractor to stop printing the SSN on the status reports. We do not need the SSN on them. They are sent to my name at my address. That is good enough.
Posted by: Marv | December 20, 2007 at 04:31 PMQuestion Reference #071212-000142
Category Level 1: Ombudsman
Date Created: 12/12/2007 03:32 PM
Last Updated: 12/20/2007 03:17 PM
Status: Solved
I have been using an e-prescribing system for 8 months now and am pleased with it.
Posted by: William Braden MD | January 02, 2008 at 11:41 PM1. I pay $30 a month and it doesn't save me money or time.
2. It does make it easier to review what I have prescribed; all my prescribing records are in one place. And it's web based, so I can access it from home or the hospital regardless of what computer I am using.
3. It doesn't show what others have prescribed, except for a limited group of patients, and even then not accurately.
4. I only made the decision to go ahead after determining that an EMR was not desirable, so that I didn't have to worry about whether EMR and e-prescribing would integrate.
5. Would Secretary Leavitt *please* get the DEA to make the decision to allow e-prescribing of controlled drugs? Fortunately many pharmacies will accept a fax with an electronic signature, but when they follow the rules, I have to transmit the prescription twice. Meanwhile, my secretary can phone in the same prescription; this is not logical. The DEA has had years to work on this. They held a big conference 18 months ago on it and still nothing has happened. Believe it or not, Congress may act faster on this issue.
I would like all the physicians, who say they can't afford an eprescribing system, to know about NEPSI. Through NEPSI, every physician in the US can have a FREE eprescribing system.
Posted by: Maureen | January 11, 2008 at 04:17 PMAlso, to address the issues of interconnectivity between pharmacies and/or mail order programs, there are software companies that provide that too.
Thank you.