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Senators Push for Vote to Extend Medicare Drug
Program Deadline
House sponsor fears a vote because House may repeal
the program
April 20, 2006 While Senators are pushing hard
for a vote on a bill to extend the Medicare drug program enrollment
deadline past May 15, Rep. Pete Stark (D-Calif.) is not pushing hard on
his bill in the House. He says the Bush administration should extend the
deadline without legislative action because, he says, the House may
repeal the whole program. In other news, insurance companies are mailing
letters to senior citizens threatening to cut off prescription drug
service for non-payment, while many of the seniors say they have paid,
according to a report by KaiserNet.org.
 Senators Call
for Vote on Extending Medicare Prescription Drug Benefit Deadline
Forty-eight senators on Wednesday sent a letter to
Senate Majority Leader Bill Frist (R-Tenn.) asking him to address
legislation that would extend the current May 15 deadline for enrollment
in the Medicare prescription drug benefit, the
Boston Globe
reports.
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Related Stories |
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Medicare Says 30 Million Senior Citizens Now Have
Drug Coverage
Over 93 million prescriptions
filled in March; stand-alones jump 1.7 million
April 20, 2006 With the deadline for enrollment
only days away (May 15), Medicare announced today that more than 30
million Medicare beneficiaries are receiving prescription drug coverage,
including more than 8 million beneficiaries who have gotten new,
individual prescription drug coverage since the program began. More than
93 million prescriptions were filled for beneficiaries during
March - averaging 3 million prescriptions filled per day.
Read more...
Medicare Drug Plan Deadline Extension Not Legal,
Says CMS
April 18, 2006 With the May 15 deadline for
enrolling in the Medicare Drug Program less than a month away, the
voices begging for an extensions are growing louder, but the deputy
administrator at the Centers for Medicare and Medicaid services says
there is no legal way to extend the deadline. The media, too, seems to
have increased its interest in the program, including the announcement
that rates are going up about seven percent in 2007, according to a
round-up of Medicare news by KaiserNet.org.
Read
more...
Choose Carefully as Medicare Drug Benefit Deadline
Nears on May 15
Kaiser Family Foundation
finds wide variations
across plans
April 14, 2006 - Medicares new private stand-alone drug plans vary
significantly in terms of covered drugs, out-of-pocket costs for
specific medications, and restrictions placed on the use of certain
drugs - according to a new analysis released today by the Kaiser Family
Foundation.
Read more...
Final Medicare Enrollment Effort Begins Monday
Across the U.S.
Hundreds of events
planned for 'Medicare Rx Get Enrolled Week'
April 12, 2006 With the deadline for enrollment
for the Medicare drug program looming May 15 and new polls showing
satisfaction with the program, a week-long grassroots effort is being
held April 17-23 in all 50 states and Washington D.C. to help senior
citizens get enrolled. Medicare Today, a national partnership of more
than 400 organizations, today announced "Medicare Rx Get Enrolled Week."
Medicare experts and volunteers will provide seniors with the
information they need to make decisions about enrollment in Medicare's
prescription drug benefit.
Read more...
Read more
on
Medicare Drug Program |
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The letter, which was written by Sens. Bill Nelson
(D-Fla.) and Olympia Snowe (R-Maine), urges Frist to bring to a vote one
of the recently introduced bills to extend the deadline (Krasner, Boston
Globe, 4/20).
Nelson has introduced a bill (S
1841) that would extend the enrollment deadline and is
co-sponsoring similar legislation (S
2168) with Snowe. Last month, the Senate voted 49-49 to
reject a budget resolution amendment introduced by Nelson that would
have extended the deadline to December 31 (Schuler, CQ Today, 4/19).
In the letter, Nelson and Snowe said, "By extending
the enrollment deadline and delaying late enrollment penalties, we can
make sure that our constituents are not forced to make hasty decisions
about their health care" (St.
Petersburg Times, 4/20). The letter adds, "Sorting through
these plans has proven to be difficult and time consuming ... the
Medicare drug program is experiencing a variety of implementation
problems that have disproportionately affected the most vulnerable
beneficiaries."
Comments
Sen. Debbie Stabenow (D-Mich.), who signed the letter, said, "From every
angle, [the drug benefit] has been a disaster, and it needs to get
fixed," adding, "In the short-run, we need at least to give folks more
time to be able to figure this out" (Kleffman,
Contra Costa Times,
4/20).
Sen. Edward Kennedy (D-Mass.) said in a statement,
"Our seniors deserve to be given every opportunity in choosing a drug
plan that best fits their needs and not held to unrealistic deadlines.
It's clear that America's seniors have experienced immense difficulty
with the administration's prescription drug program ..." (Boston Globe,
4/20).
Meanwhile, Rep. Pete Stark (D-Calif.) said that 187
House members have signed a discharge petition on his own deadline
extension bill (HR
3861), which has more than 160 co-sponsors (CQ Today, 4/19).
However, he said the administration should act to extend the deadline
without legislation because if an extension bill reaches a vote in the
House, lawmakers might decide to repeal the entire program (Contra Costa
Times, 4/20).
CMS
has said it will
allow
some low-income beneficiaries to enroll in the drug benefit after the
deadline without financial penalty (Boston Globe, 4/20). However, Bush
administration officials last week
said
that CMS lacks the legal authority to extend the deadline for all
beneficiaries (St. Petersburg Times, 4/20).
CMS spokesperson Peter Ashkenaz on Wednesday said,
"The administration doesn't support an extension," adding, "Enrollment
is surpassing our goals, satisfaction is high, and we see no reason to
extend a deadline that's working. We don't' want Medicare beneficiaries
to put off savings" (Boston Globe, 4/20).
Disenrollment Letters
In related news, insurers sponsoring Medicare drug plans have mailed
"tens of thousands" of letters to beneficiaries saying they will be
disenrolled from the drug benefit because they have not paid their
premiums,
USA Today
reports.
The letters say that if missed payments are not
made by May 31, "we will have to disenroll you." However, "many who
received the letters in the past few days insist they have already
paid," USA Today reports.
Some beneficiaries said they have signed up for
automatic deductions from their Social Security checks to pay for
premiums, while others who received the letters qualify for a low-income
subsidy that covers the cost of premiums, according to officials with
beneficiary counseling programs in Arkansas, California, New York and
Pennsylvania.
Jackie Kosecoff, an executive at
UnitedHealth,
which has 4.5 million beneficiaries enrolled in Medicare drug plans,
said the insurer mailed letters to beneficiaries who are one to four
months behind in payments. UnitedHealth spokesperson Dominick Washington
said the letters inform beneficiaries of payment options and assure them
they will not be disenrolled because of late payments.
CMS officials said a one- to two-month delay in
processing enrollment in Social Security's automatic deduction program
might be partly to blame for the problems. CMS Administrator Mark
McClellan added that officials are "seeing only a low rate" of questions
related to such billing issues (Appleby, USA Today, 4/20).
Language Agreement
Meanwhile, organizations representing the insurance industry, chain drug
stores and community pharmacists have agreed on uniform language for
informing pharmacists of coverage policies for different drug plans,
CQ HealthBeat
reports.
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Center for Medicare Advocacy Wants Deadline
Extension
Judith Stein, one of the nation's leading experts on Medicare
and the executive director of the Center for Medicare Advocacy,
is calling for our government to extend the deadline to sign up
for Medicare Part D (prescription drug coverage). Seniors and
disabled people who don't sign up for Medicare Part D by May 15
will face penalties if they sign up later. The Center for
Medicare Advocacy understands that the government has been asked
to extend the deadline and has declined - they think this is a
bad decision because:
1. Part D is brand new, and even the President agrees,
complex. The first few months of the program's implementation
was widely acknowledged to be a mess. People need time to get
over that rocky start and to have enough confidence in what they
are choosing to enroll.
2. It is difficult to obtain complete information about the
actual cost of needed drugs. The prices of drugs vary
dramatically from plan to plan, and plans have changed prices
and their lists of covered drugs. Seniors should get enrollment
packages in writing from the plans they are interested in so
that they can study them, and this takes time.
3. People can't switch plans, so it is not fair to force them to
enroll before they are comfortable with their decision.
The Center for Medicare Advocacy is working to increase access
to comprehensive Medicare coverage and health care for elders
and people with disabilities. I'm happy to set up an interview
with Judith Stein, if you'd like. For more information about
her and the Center for Medicare Advocacy, please see
http://www.fairmedicare.org/. |
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The standardized language will indicate to
pharmacists whether a particular drug is covered, whether prior
authorization is required for a drug, whether coverage limits have been
exceeded and whether a pharmacy is part of a plan's network. Pharmacists
and insurance industry representatives said the agreement will help
reduce wait times and confusion among beneficiaries filling
prescriptions.
Bruce Roberts, executive vice president and CEO of
the
National Community
Pharmacists Association, said the agreement "will make a
tremendous difference to pharmacists delivering drugs in a timely
fashion." McClellan also said the agreement would reduce the "time and
effort of pharmacists" filling prescriptions. "We expect the entire
industry to implement these practices as soon as possible," he said
(Carey, CQ HealthBeat, 4/19).
MedPAC
The
Medicare Payment
Advisory Commission on Wednesday considered data from a
MedPAC survey of Medicare beneficiaries' experiences with the drug
benefit. According to CQ HealthBeat, MedPAC is in the process of "wading
into Part D issues by reviewing the quality of information" that
beneficiaries have available when making decisions about the program.
According to MedPAC staffer Joan Sokolovsky, the
data show that half of beneficiaries surveyed spent at least eight hours
making a decision about the drug benefit. About two-thirds of
beneficiaries said they made a decision by themselves, while a few said
they sought help only from doctors, pharmacists or counselors. Only 11%
used the Medicare Web site, while 22% called the Medicare phone line for
help on selecting a plan, the survey shows.
MedPAC Commissioner David Smith, who participated
in MedPAC-sponsored focus groups with beneficiaries, said there was a
"lot of anger" among beneficiaries who thought the enrollment process
was "too confusing" and "too hard." However, he added that once
beneficiaries successfully filled a prescription, they expressed "a
surprising amount of satisfaction" (Reichard, CQ HealthBeat, 4/19).
Broadcast Coverage
APM's "Marketplace"
on Wednesday reported on the advisory opinion that pharmaceutical
companies' patient-assistance programs for low-income Medicare
beneficiaries are lawful under the prescription drug benefit.
The segment includes comments from Robert Hayes,
president of the
Medicare Rights
Center; Ian Spatz, vice president for public policy at
Merck;
former Rep. Billy Tauzin (R-La.), president of the
Pharmaceutical
Research and Manufacturers of America; and a low-income
Medicare beneficiary who participated in a patient-assistance program
(Palmer, "Marketplace," APM, 4/19).
 The
complete segment is available
online
in RealPlayer.
"Reprinted with
permission from 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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