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Welcome to the first homepage edition of i2P for 2012.
In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011.
One of those items for i2P was that a third-party provider to the site did not advise of a code change to the security section in our subscribe panel, creating a range of frustrated subscribers not able to get on board.
We apologise to all those potential subscribers who were unable to register with us in the second half of 2011, but if you try once more you should have no problem.

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Guild’s eRx clarification camouflages the facts!! Why hide the truth?

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James Ellerson articles by this author...

James Ellerson is passionate about developing primary health care services across the spectrum of all health care practitioners working in a practical alliance, whether in an urbanised or a remote setting. He sees a wide range of opportunities for all health professionals who are currently held back by lethargic leadership. Attitudinal change is now under way because of new directions being set by governments both globally and in Australasia, creating empowerment of patients, better systems of delivery, with all resulting in primary health care at an optimum level.

The thought that first struck me after reading ‘the clarification’ about the eRx Script Exchange on the editorial page of the May Issue of the Pulse+IT magazine was - Why is this clarification so necessary?
On the surface it seemed like a reasonable statement to make.
It read: “Clarification - in the March 2010 edition of Pulse+IT it was reported that the electronic prescribing service operated by eRx Script Exchange had received 7.5 million scripts "sent to the eRx script hub by prescribers" as of the middle of January.  
Omitted from the article was reference to a workflow that allows pharmacists to send repeat prescriptions to the hub for later retrieval by any pharmacist connected to the eRx system.
The volume of transactions quoted in the March 2010 article included such scripts, in addition to scripts sent to the hub directly by prescribers.”

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 I found the clarification intriguing; particularly the comment “Omitted from the article was reference to a workflow that allows pharmacists to send repeat prescriptions to the hub for later retrieval …. “.

It seemed at first as though the information in the March 2010 edition must have been misleading or inaccurate, thus necessitating this attempt to put the record straight! 
However, on closer examination this ‘clarification’ appeared even more misleading than ever. 
Let me explain.

15 cents / script subsidy for pharmacists

To be eligible for the government’s 15 cent per script subsidy, introduced on 1 July 2010, a script and its repeats must be transmitted electronically from the prescribing source (ie the medical practitioner) to the hub and then downloaded from the hub and dispensed by a pharmacist before the subsidy can be claimed.

Closer examination of the ‘clarification’ in question seems to infer that a large proportion, if not most, of the 7.5 million scripts received by eRx Script Exchange, as at the middle of January, have not been sent electronically by prescribers to the eRx Script Exchange hub.
Indeed, the ‘clarification’ seems to indicate that most of the 7.5 million scripts have been uploaded into the eRx script hub directly by pharmacists (not by prescribers) so that a pharmacist can then retrieve the script for dispensing purposes, either immediately or at some future date.

Now this raises the question of the potential for pharmacists to inadvertently and unknowingly perpetrate a fraud against Medicare, in that, if each script downloaded from the hub and dispensed by a pharmacist is used to claim the 15 cent subsidy, then a pharmacist may be illegally claiming a 15 cent subsidy for scripts that were never delivered electronically to the hub from the originating prescriber!
This is clearly outside the 5 CPA rules for the e-script payment.

Let us make the assumption that of the 7.5 million scripts referred to in the ‘clarification’, 6 million of them, 80%, were scripts and repeats which were loaded into the eRx hub by a pharmacist. It might be a few more or less. Even so, at 15 cents per script/repeat the revenue generated in this way would be almost $1 million.   As the subsidy only commenced on 1 July 2010 no fraud will have occurred prior to that date. However, the potential for fraud after 1 July 2010 is very real indeed.

It may be perpetrated quite innocently by pharmacists who are unable to identify which of the scripts downloaded from the Guild’s eRx Script Exchange are legally entitled to the 15 cent subsidy.  It is clear that all scripts, including repeats, which do not reach the script exchange hub via an electronic transmission from a prescribing doctor, are not legally entitled to the 15 cent subsidy.

Not to put too fine a point on it 'further clarification' from the Guild and its eRx Script Exchange is urgently required. It should be unambiguous and widely disseminated. 
This will be particularly important for every pharmacist who uses the Guild’s eRx system to lodge a claim, as it is reasonable to expect that it will be the pharmacist who will be liable for any fraudulent claim against Medicare and not the eRx service provider.

This next ‘clarification’ should retract the 7.5 million claim as it is quite deceptive.
Further, it should very clearly state the true situation starting from the time covered by the 7.5 million claim.
In putting the record straight it should state, on a month by month activity basis, the actual number of scripts and repeats received by the eRx Exchange electronically from a medical prescriber and the number of scripts and repeats uploaded into the eRx Exchange by pharmacists. 
The total of scripts and repeats received from both sources over the period in question should be 7.5 million.

Finally, to protect all pharmacists the Guild’s eRx Exchange provider should outline what steps they are taking to ensure inappropriate claiming of the 15 cent subsidy cannot occur in the future.

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