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Medicare Drug Program
Flurry of Enrollees in Medicare Drug Program on Last
Day
Efforts growing to waive the penalty for late
enrollment
May 16, 2006 – As was expected, there was a surge
of enrollment in the Medicare drug program yesterday, which was the last
day to enroll without paying a penalty for enrollment in future years.
The daily report on Medicare by KaiserNet.org says efforts are still
building to eliminate the late-enrollment penalty. A contributing factor
to some Republicans joining this push is a realization that many seniors
in the drug program will be hitting the "doughnut hole" in the plan at
about election time. This is the level in the plans where seniors must
pay the full cost for their prescription drugs.
 Medicare Drug Benefit Experiences 'Surge' in
Enrollment Activity Before Sign-up Deadline
A surge in enrollment before the May 15 deadline
for signing up for the Medicare prescription drug benefit could mean
that more than 90% of Medicare beneficiaries will have prescription drug
coverage in the first year of the program,
CMS
Administrator Mark McClellan said on Monday,
CQ HealthBeat
reports.
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Related Stories |
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Key Republicans Oppose Late Enrollment Penalty for
Medicare Drug Program
May 15 is last day
to enroll without future enrollment penalty
May 15, 2006 – With still about 5.7 million senior
citizens not signed up for a Medicare drug plan, Democrats and, now,
some Republicans are asking that the penalty for late enrollment be
waived. The Centers for Medicare and Medicaid Services announced last
week that it will not penalize low-income seniors who miss the deadline
but continues to oppose the waiver for all seniors. About half of those
not enrolled could qualify for the low-income exemption, according to
a report by KaiserNet.org.
Read more...
Medicare Says 37 Million in Drug Program Approaching
May 15 Deadline
May 12, 2006 – With just four days left to enroll
in a Medicare drug plan before the first year deadline of May 15,
Medicare says over a million more people have enrolled in prescription
drug coverage between late April and May 6, bringing the total of
beneficiaries with prescription drug coverage to 37 million. But, it
seems certain that millions will not join by the deadline and will face
a stiff penalty for joining in future periods.
Read
more...
Massive Last Week Push to Enroll Seniors in Medicare
Drug Program
Missing May 15 deadline means paying at least 7%
more for program in future
May 8, 2006 – With only a week left for senior
citizens to enroll in the Medicare drug program without a penalty for
enrolling in future years, Medicare has launched a massive effort to get
seniors enrolled by the May 15 deadline. Those who do not make it will
have to wait until November to enroll and will pay 7 percent higher
premiums – for as long as they are enrolled. The daily Medicare report
by KaiserNet.org also reports Democrats are saying they want to change
the law to allow Medicare to negotiate with pharmaceutical companies for
better prices on Medicare drugs.
Read
more...
Poor Communications on Medicare Drug Plan May Be
Reason Enrollment Lags
GAO tells CMS to improve hotline and Website
May 4, 2006 – With the deadline (May 15) for
enrolling in the first year of the Medicare drug program rapidly
approaching, the Government Accountability Office may have found the
not-very-surprising reason many senior citizens have not enrolled – the
communications about the program have not been very good. The Centers for
Medicare and Medicaid Services said it is taking action to make the
suggested improvements, although the agency said the findings were not a
complete and accurate picture.
Read
more...
Read more
on
Medicare Drug Program |
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The Bush administration last Wednesday said about
37 million
Medicare beneficiaries -- or 85% of the approximately 43 million total
beneficiaries -- had some form of prescription drug coverage.
According to CQ HealthBeat, "Breaking 90% would put
that figure at about 38.7 million" (Reichard, CQ HealthBeat, 5/15).
CMS spokesperson Lorraine Ryan said about 72,000
beneficiaries signed up for the drug benefit online on Friday, three
times the number who enrolled online the previous Friday (Salganik,
Baltimore Sun,
5/16).
Over the weekend, five times as many beneficiaries
enrolled online than had the previous weekend, McClellan said. In
addition, as many as 40,000 to 50,000 people were on the Medicare Web
site at any given time over the last few days, he said. Calls to
1-800-MEDICARE averaged about 300,000 per day last week, compared with
200,000 to 250,000 the week before, McClellan said (CQ HealthBeat,
5/15).
The agency was receiving about 140,000 calls per
day two months ago, Ryan said. Better estimates of final enrollment
figures should be available Tuesday, she said (Baltimore Sun, 5/16).
McClellan said, "We've seen a real surge. The deadline is making a
difference" (Freking,
AP/Long Island
Newsday, 5/16).
Enrollment Efforts
Across the U.S. on Monday, state and local governments, advocacy
groups, seniors' organizations, insurers and pharmacies held enrollment
events to encourage beneficiaries to sign up before the deadline, after
which most beneficiaries will have to pay a penalty (Baltimore Sun,
5/16).
Beneficiaries who were eligible to enroll in the
drug benefit Monday who did not sign up will have to pay a penalty of a
1% premium increase for each month of delayed enrollment.
Because the next enrollment period begins Nov. 15,
beneficiaries would pay a minimum late-enrollment penalty of 7%.
Beneficiaries who qualify for a low-income subsidy under the drug
benefit and beneficiaries with disabilities are exempt from the penalty.
Hurricane Katrina evacuees also will be allowed to enroll without a
late-enrollment penalty for 63 days after May 15 but will have to pay a
2% penalty beginning the 64th day (Kaiser
Daily Health Policy Report, 5/15).
In Washington, McClellan,
HHS
Secretary Mike Leavitt and first lady Laura Bush attended an enrollment
event at a church. Administration officials and other groups
participated in about 1,000 similar events across the country in the
last week, CMS spokesperson Peter Ashkenaz said (CQ HealthBeat, 5/15).
Nationwide,
My Medicare Matters,
an affiliate of the
National Council on
Aging, held more than 3,000 events (Baltimore Sun, 5/16). In
addition, at least 12 Republican House members planned to keep their
offices open until midnight Monday to help beneficiaries enroll, while
other lawmakers held events in their congressional districts (Wolf,
USA Today,
5/16).
Phone Lines, Incomplete Applications
Meanwhile, calls to insurers -- which had been urged by the Bush
administration to add extra phone operators to handle the last-minute
enrollment surge -- showed varying wait times Monday, the
New York Times
reports.
Calls to
UnitedHealthcare
generally were answered in less than two minutes, but callers to
Humana
often had waits of more than 30 minutes, according to the Times.
Calls to 1-800-MEDICARE often took more than 15
minutes (Pear, New York Times, 5/15). Beneficiaries who called the
Medicare phone line on Monday but were unable to get through could leave
their names and phone numbers, and they would be called back within a
few days to enroll without penalty, Ryan said (Baltimore Sun, 5/16).
Medicare officials also told insurers they could
accept incomplete applications on Monday if beneficiaries provided the
missing information soon after the deadline. On Humana's phone line,
callers were told they could "meet enrollment deadline requirements" by
leaving their names and phone numbers on an answering machine. Callers
were told that a Humana representative would "call [them] back in the
next few days" to help choose a drug plan (New York Times, 5/16).
Penalty Waiver
Meanwhile,
House Ways and
Means Health Subcommittee Chair Nancy Johnson (R-Conn.) on
Monday said she was drafting legislation that would eliminate the
late-enrollment penalty for beneficiaries who missed Monday's deadline.
The bill would maintain Nov. 15 as the start of the
next enrollment period but would waive the late-enrollment penalty for
beneficiaries who were eligible this enrollment period who did not sign
up. A press release from Johnson's office said she will introduce the
bill as "quickly as possible" for consideration before the current
legislative session adjourns (CQ HealthBeat, 5/15).
Jill Gerber, a spokesperson for
Senate Finance
Committee Chair Chuck Grassley (R-Iowa), said the senator
will not make a decision on whether he supports eliminating the penalty
until after he sees final enrollment figures, which could be as early as
Tuesday (Schuler, CQ Today, 5/15).
Karen Ignagni, president of
America's Health
Insurance Plans, said her group supports waiving the penalty,
adding that doing so would act as an incentive to encourage more
beneficiaries to sign up (CQ HealthBeat, 5/15).
AARP
also has expressed support for waiving the penalty (Alonso-Zaldivar,
Los Angeles Times,
5/16).
Comments
Johnson said, "We might be closer to 100% coverage if the Democrats
had put the welfare of our seniors ahead of their own political
ambition," adding, "Although the penalty in existing law is not harsh,
it is more the principle that no senior should be made to pay for the
Democrats' posturing over the past year" (CQ Today, 5/15).
House Minority Leader Nancy Pelosi (D-Calif.) said,
"After months of ignoring the pressing needs of seniors, Republicans are
running for political cover by claiming they want to waive the penalty
they imposed. Waiving the penalty does not do enough" (AP/Long Island
Newsday, 5/16).
Pelosi said Democrats also want to "extend the
deadline," and "allow seniors the opportunity to opt out of a plan if it
doesn't work for their health needs" (CQ HealthBeat, 5/15).
Drew Altman, president of the
Kaiser Family
Foundation, said the late enrollment penalty and the
so-called "doughnut hole" gap in coverage under the drug benefit "are
going to be hitting around the time of the election." He added, "It will
be a lot easier to solve the enrollment penalty than to plug the
doughnut hole" (Los Angeles Times, 5/16).
Meanwhile, the Bush administration remained
"noncommittal" on Monday about whether it would waive the penalty or
extend the deadline, the Sun reports. White House spokesperson Tony Snow
said, "I'm not going to give you a categorical answer. The deadline is
the deadline" (Baltimore Sun, 5/16).
States
In other drug benefit news, California legislators on Monday
approved an emergency bill to allow the state to continue covering the
costs of medications for dual eligibles who have been unable to obtain
prescription drugs under the Medicare drug benefit.
The legislation would authorize the state to
continue until the end of January 2007 paying for medications for
beneficiaries in Medi-Cal, the state Medicaid program, who had their
prescription drug coverage transferred to Medicare under the drug
benefit. Many dual eligibles were incorrectly charged copayments or
experienced other problems obtaining medications after the drug benefit
began.
As of May 9, California has spent $65.7 million to
pay for prescriptions for dual eligibles. The state has set aside $120
million for the program, which would expire on Tuesday without the
emergency measure. The state Assembly voted 56-5 to continue the
program.
The bill, which included amendments from the state
Senate, is expected to be signed by Gov. Arnold Schwarzenegger (R)
(Lawrence,
AP/Contra Costa
Times, 5/16).
Separately, Illinois officials said low-income and
disabled Medicare beneficiaries who did not meet Monday's enrollment
deadline can receive prescription drug coverage through the state
pharmaceutical assistance plan through Dec. 31. To qualify for the
program, called Illinois Cares Rx, beneficiaries must have annual
incomes of $19,600 or less or $21,218 for beneficiaries with cancer or
certain other conditions.
For beneficiaries already enrolled in the Medicare
drug benefit and Illinois Cares Rx, the state program will pay for any
premiums, copayments or coverage gaps not covered by Medicare.
Beneficiaries already enrolled in the drug benefit who have not signed
up for Illinois Cares Rx will not be eligible for the state program
(Graham,
Chicago Tribune,
5/16).
Broadcast Coverage
Several broadcast programs reported on the enrollment deadline for
the drug benefit:
 APM's
"Marketplace
Morning Report": The segment includes comments from Robert
Laszewski, political analyst and health consultant for the insurance
industry, and Joe Paduda, a health care consultant (Tong, "Marketplace
Morning Report," APM, 5/15). The complete segment is available
online
in RealPlayer.
 CBS'
"Evening
News": The segment includes comments from Medicare
beneficiaries (Andrews, "Evening News," CBS, 5/15). The complete segment
is available
online
in RealPlayer.
KCRW's
"To
The Point": The segment includes comments from McClellan;
Tricia Neuman, a Kaiser Family Foundation vice president and director of
its
Medicare Policy
Project; Ron Pollack, executive director of
Families USA;
Rob Pollock, member of the Wall Street Journal editorial board; and
Medicare beneficiaries (Olney, "To The Point," KCRW, 5/15). The complete
segment is available
online
in RealPlayer.
PBS'
"NewsHour
with Jim Lehrer": The segment includes comments from Dan
Mendelson, president of
Avalere Health,
a health care consulting firm, and Pollack (Suarez, "NewsHour with Jim
Lehrer," PBS, 5/15). 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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