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Governors Head to White House for Answers on
Medicare Drug Program
Many concerned about
repayment for covering dual eligibles
Feb. 27, 2006 – Governors will meet today with
President Bush and his cabinet and high on their list of topics to
discuss will be repayment for expenses the states have incurred in
providing drugs to the "dual eligibles" that could not get their
medications when the new Medicare drug program took effect on January 1,
according to the Kaiser Daily Report. The Governors have been in
Washington for two days of the National Governors Association meeting,
which has been focused on health care.
 Kaiser Daily Health Policy Report on state
developments related to the Medicare Prescription Drug Benefit
Concerns about the Medicare prescription drug
benefit are expected to be some of the "main issues" governors will
raise on Monday in a meeting with President Bush and his Cabinet, the
AP/Arizona Daily Star reports (AP/Arizona Daily Star, 2/26).
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Texas, California are Leaders in Medicare Drug
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State-by-state results released
Feb. 24, 2006 - Texas leads the nation in the
number of senior citizens who have enrolled in stand-alone Medicare drug
plans but California is the run-away leader in total enrollment and in those getting drug
coverage through Medicare Advantage programs, according the
state-by-state results on Medicare prescription drug program enrollment,
which were released yesterday by Health and Human Services.
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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 Officials Say Computer Glitches Main Cause of Drug Program
Problems
Jan. 27, 2006 - At a forum sponsored yesterday by
the Kaiser Family Foundation, officials from the Centers for Medicare &
Medicaid said most of the problems senior citizens were having with
enrollment in the new prescription drug plans were problems created by
the computer system. CMS "SWAT Teams" are working on the problems and
others participating in the program praised them for their efforts. It
is reported in today's Daily Health Policy Report by KaiserNet.org.
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CMS
Administrator McClellan Says States Assisting Medicare
Beneficiaries With Access to Medications Will Be Reimbursed
Jan. 25, 2006 - The federal
government will reimburse states for expenses they incur by covering
the cost of prescription drugs for Medicare beneficiaries who have
had difficulty obtaining medications under the new drug benefit, the
Bush administration said on Tuesday, the
New York Times reports (Pear, New York Times,
1/25).
Read more...
Read more
Medicare Drug Program |
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The
National Governors Association's winter meeting began in Washington,
D.C., on Saturday (Tanner, AP/Tennessean, 2/25). Governors likely will
raise concerns about "clawback" payments states must make to the federal
government under the drug benefit and discuss a timeline for
reimbursements from the federal government for expenses states incurred
during start of the drug benefit, according to the AP/Daily Star
(AP/Arizona Daily Star, 2/26).
Under the 2003 Medicare law, Medicare assumes
prescription drug costs for dual eligibles -- individuals eligible for
both Medicaid and Medicare -- and states will have to pay the federal
government as much as 90% of the estimated amount that they would have
spent on Medicaid coverage for medications for dual eligibles, otherwise
known as a clawback payment.
The rate will decrease to 75% over time (Kaiser
Daily Health Policy Report, 2/10). Some governors are concerned
about making the clawback payments to the federal government while also
covering expenses for prescriptions for dual eligibles who experienced
problems obtaining medications under the drug benefit, the AP/Daily Star
reports. Many states took emergency steps to ensure that dual eligibles
could access prescriptions after reports that beneficiaries were
experiencing problems obtaining medications under the drug benefit.
The federal government has said it will reimburse
states for expenses related to emergency measures taken to ensure that
dual eligibles could access medications (AP/Arizona Daily Star, 2/26).
Huckabee Campaign, Medicaid Changes
The first two days of the NGA meeting focused on Arkansas Gov. Mike
Huckabee's (R) "Healthy
America" initiative, a program to promote anti-obesity efforts
(Reichard, CQ HealthBeat, 2/24).
In a speech on Saturday, Huckabee, chair of NGA,
highlighted existing state anti-obesity programs and urged cultural
changes that would change perceptions of obesity in ways similar to
campaigns against littering, smoking, and drinking and driving.
Policy discussions were expected to begin Monday,
including the meeting with Bush and cabinet officials (AP/Tennessean,
2/25).
At a separate session Monday afternoon, governors
will meet with
CMS Administrator Mark McClellan to discuss changes to Medicaid.
According to
CQ HealthBeat, McClellan will advise governors on "how they can take
advantage of benefits flexibility, copayment, prescription drug and
asset transfer provisions to save money."
The session will also include discussions with
Scott Beeken, an executive with Great American Insurance; Mark
Birdwhistell, secretary of the
Kentucky Cabinet for Health and Family Services; and Chris Jennings,
White House health care adviser under President Clinton (CQ HealthBeat,
2/24).
Two states recently took action related to the
new Medicare prescription drug benefit. Summaries appear below.
California: California will withdraw from a
proposed lawsuit against the federal government to challenge the
"clawback" provision of the Medicare prescription drug benefit, state
Attorney General Bill Lockyer (D) announced Thursday, the
Los Angeles Times reports (Los Angeles Times, 2/24).
Under the clawback provision of the drug benefit,
Medicare will assume the prescription drug costs for dual eligibles, but
states will have to pay the federal government as much as 90% of the
estimated amount they would have spent on Medicaid coverage for
medications for residents dually eligible for Medicare and Medicaid.
The rate will decrease to 75% over time. California
would have lost $130 million over two years under the original
calculation, but the administration of Gov. Arnold Schwarzenegger (R)
said the state will save $60 million under a new calculation the Bush
administration announced on Feb. 9.
HHS Secretary Mike Leavitt said states' clawback
payments will be 25% less than previously anticipated through 2015 (Kaiser
Daily Health Policy Report, 2/10). Lockyer said the federal
government has told state officials that California would not have to
make payments to the federal government under the clawback provision
(Los Angeles Times, 2/24).
Vermont: Beginning March 8, Vermont will
switch nearly 25,000 state residents back to the Medicare prescription
drug benefit after having covered their prescription costs for the last
six weeks, a government official announced on Wednesday, the
Burlington Free Press reports.
Vermont and about two dozen other states have
temporarily covered prescription drug costs for low-income Medicare
beneficiaries who reported problems with access to medications under the
new prescription drug benefit.
Joshua Slen, director of the
Office of Vermont Health Access, said that 80% of those residents
now are properly enrolled in the Medicare program. The state will
continue to pay for prescriptions for the remaining beneficiaries whose
eligibility still needs to be determined, according to Slen.
He said the March 8 deadline gives beneficiaries
and pharmacists two weeks to prepare to handle any problems they might
encounter. "This is a federal program that we believe has made
significant strides," Slen told the state House Human Services
Committee, adding, "I would not be here if I didn't think we could pull
this off."
However, senior advocates said it is too early for
the state to make the move. "What's being proposed is placing an
unnecessary burden on seniors at the pharmacy counter," Michael Sirotkin
of
Community of Vermont Elders said (Hallenbeck, Burlington Free Press,
2/23).
"Reprinted with
permission from kaisernetwork.org (insert hyperlink to http://www.kaisernetwork.org).
You can view the entire
Kaiser Daily Health Policy Report, search the archives, and sign up
for email delivery at
www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser
Daily Health Policy Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. © 2006 Advisory Board Company and Kaiser Family Foundation.
All rights reserved.”
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