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'These are Our Problems to Solve,' Declares HHS
Secretary in Medicare Drug Benefit Progress Report
Feb. 2, 2006 – New estimates released yesterday by
Health and Human Services show the costs of the Medicare drug benefit
are significantly less than expected. In a one-month progress report,
Secretary Mike Leavitt also said HHS and the Medicare drug plans are
taking actions to improve the drug programs performance. "We make no
excuses. These are our problems to solve," he said in releasing the
report.
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Medicare Drug Program |
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The report details action steps HHS and health
plans are taking, such as extending transition coverage for a
beneficiary’s current drugs to 90 days and reducing call wait times.
“While the new prescription drug benefit has worked
for the vast majority of participants, the first trip to the pharmacy
has been frustrating for some, particularly for certain people with
Medicare and Medicaid. We make no excuses. These are our problems to
solve and this report shows that we are making progress,” Secretary
Leavitt said.
“We are working around the clock to help everyone
use their coverage,” said Dr. Mark McClellan, Centers for Medicare &
Medicaid Services Administrator. “As we improve our data exchanges with
plans, provide new support for pharmacists, work with states, and help
beneficiaries who call 1-800-MEDICARE resolve any problems, many more
beneficiaries are using their new coverage every day.”
Secretary Leavitt announced that Medicare will
notify plans that the 30-day transitional coverage period in effect will
continue for 60 more days -- in effect, this means that plans will
provide up to 90 days of coverage for a beneficiary’s current drugs.
This provides more time for beneficiaries to find out if they can save
by using other drugs that work in a very similar way and cost
significantly less. This action reinforces steps already taken by many
plans, like extending their transitional coverage, to help ensure a
smooth transition for beneficiaries.
Leavitt noted that call wait times for pharmacists
and customers had been “unacceptable,” and announced efforts to get them
significantly reduced.
The call-wait time for 1-800-MEDICARE has been
around five minutes since the beginning of January, and, at the end of
the month, the time was even shorter (less than a minute). While most
plans have also taken steps to reduce wait times for customers and
pharmacists to acceptable levels, HHS will increase its monitoring and
reporting of drug plan wait times and will take corrective actions in
the specific cases where plans do not improve.
The progress report also highlights new information
about significant savings for taxpayers. The Secretary notes that the
latest estimates show that the costs of the Medicare prescription drug
benefit are significantly less than expected. Examples include:
● Latest estimates project premiums of $25 a
month - about a third less than previously estimated.
● The federal government is now projected to
spend about 20 percent less per person in 2006 and, over the next five
years, payments are projected to be more than 10 percent lower than
first estimated.
The savings result from lower expected costs per
beneficiary; projected enrollment in the drug benefit has not changed
significantly.
At the report’s conclusion, the Secretary outlines
action steps that Medicare is taking, including:
● Making sure drug plans have up-to-date
information on all their dual eligible beneficiaries;
● Improving the “data translation” between Medicare, health plans and
states;
● Calling 1-800-MEDICARE means virtually no wait time;
● Monitoring and reporting call wait times for drug plans;
● Assuring plans meet contractual payment terms for pharmacies;
● Extending transition coverage for a beneficiary’s current drugs to
90 days;
● Working with the states to assure a backup system is no longer
needed;
● Establishing a reimbursement plan for the states and if needed,
providing a temporary extension to state reimbursement plan; and
● Continuing the process of problem-solving and improvement -- guided
by the lessons learned.
The Secretary added, “The measure of our success
should not be that we have no unexpected problems at the outset but
rather that we find, fix and finish with these problems quickly so that
all seniors have access to coverage that saves them money, keeps them
healthier and gives them peace of mind.”
A copy of the full report is available at
http://www.hhs.gov/secretaryspage.html.
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