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Medicare Drug Program News

Medicare Drug Program Stays in News: Agency Says Most Billing Glitches Solved

Senate-House negotiators agree to allow drug imports from Canada; More reactions to Wal-Mart's generic drug discounts; Committee forms to help fund the FDA

September 26, 2006 – The Medicare drug program stays in the news today with reports from Medicare that most of the billing "glitches" have been corrected, the House and Senate negotiators have agreed to allow drugs to be imported from Canada (it's in a Homeland Security bill), Wal-Mart's generic drug discount program is still getting reaction and a new organization has formed to lobby for more funds for the FDA to help implement the "safe drugs" recommendations of the Institute of Medicine. It is all reported in the daily report by KaiserNet.org.

Click here to the Daily Health Policy Report - KaiserNetwork.orgFewer Than 100K Medicare Beneficiaries Face Ongoing Premium Glitches, CMS Administrator McClellan Says

CMS Administrator Mark McClellan on Monday said that no more than 100,000 Medicare beneficiaries have outstanding problems regarding glitches in the payment of drug plan premiums through monthly Social Security checks, CQ HealthBeat reports.

 

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McClellan said, "When people were switching plans or initially enrolling, we probably did have hundreds of thousands with problems. At this point, we're down to probably about a hundred thousand that have issues that are not completely resolved, and we are working with Social Security to resolve the remaining cases" (Reichard, CQ HealthBeat, 9/25).

A glitch last month caused the government to erroneously reimburse about 230,000 Medicare beneficiaries for their prescription drug benefit premiums. CMS administers the drug benefit and the Social Security Administration deducts some beneficiaries' premiums from Social Security checks.

The New York Times on Monday reported that the erroneous payments were the latest of several mistakes in the "strained, often dysfunctional relationship" between CMS and SSA (Kaiser Daily Health Policy Report, 9/25).

McClellan said, "Every week, we get a significant number of these remaining ones resolved, and I expect these to continue to stay on track for resolution in the weeks ahead" (CQ HealthBeat, 9/25).

House, Senate Committees Pass Bill That Would Allow U.S. Residents To Purchase Prescription Drugs from Canada, Reject Provision That Would Allow Purchase of Medications from Mexico

House and Senate negotiators on Monday unanimously approved the fiscal year 2007 Homeland Security appropriations bill, which includes a provision that would allow U.S. residents to purchase lower-cost prescription drugs from Canada, CongressDaily reports.

 

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White House, Pharmaceutical Companies Losing Battle to Block Canadian Drugs


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The bill, which the full House and Senate likely will approve within days, would allow U.S. residents to transport personally as much as a 90-day supply of FDA-approved prescription drugs from Canada.

The legislation would exclude controlled substances and some biological products.

Negotiators rejected a proposal from House Republican leaders that would have required U.S. residents to obtain permission slips from their physicians to purchase prescription drugs from Canada.

In addition, Senate negotiators refused to vote on an amendment proposed by Rep. Chet Edwards (D-Texas) that would have allowed U.S. residents to purchase prescription drugs from Mexico, after House negotiators had voted 9-8 to approve the proposal (Strohm, CongressDaily, 9/26).

Baltimore Sun Examines Reaction to Wal-Mart's Generic Prescription Drug Program

The Baltimore Sun on Saturday examined reaction to a new pilot program announced last week by Wal-Mart Stores under which 65 company pharmacies in the Tampa, Fla., area will sell 30-day prescriptions of some generic medications for $4.

 

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Generic Drug Price War: Target Matches Wal-Mart, CVS Says Wal-Mart Plan is Meaningless


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Gerard Anderson, a professor at Bloomberg School of Public Health at Johns Hopkins University, said the program "should drive prices down." In response to the program, Target last week announced that company pharmacies will match Wal-Mart prices for generic medications, and health care experts predict that "more competitors will be forced to follow suit" as Wal-Mart expands the program nationwide, the Sun reports.

Steven Findlay, a health care analyst at Consumers Union, said, "We hope that this won't be some brief price war or some brief strategy advantage that Wal-Mart is using but really an attempt by the big-box stores to financially lower the prices of generic drugs" (Walker, Baltimore Sun, 9/23).

Group Launches Campaign To Increase FDA Funding After IOM Report Calls for Agency Reform

A new group called the Coalition for a Stronger FDA -- co-chaired by former HHS secretaries Tommy Thompson, Donna Shalala and Louis Sullivan -- on Monday launched a lobbying effort to increase funding for FDA, CongressDaily reports (CongressDaily, 9/25).

 

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Fixing Drug Safety System Requires Major Changes at FDA, Says Institute of Medicine


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At a press conference, Thompson said he plans to meet with the director of the Office of Management and Budget to discuss FDA funding for fiscal year 2008. If an agreement is not reached with the White House, the group plans to lobby Congress for more funding (Henderson, Boston Globe, 9/26).

Coalition members include the Biotechnology Industry Organization, the Advanced Medical Technology Association, the Consumer Healthcare Products Association and the Center for Science in the Public Interest.

Seventeen patients' groups are also members, including the American Heart Association, the National Alliance on Mental Illness and the Alzheimer's Association.

Thompson said budgets for NIH and CDC have doubled in recent years as FDA's budget has lagged. He said large investments at NIH are expected to lead to the development of new products and technologies that will require FDA approval.

Unless FDA funding is increased, a bottleneck for patient access to new treatments could emerge, Thompson said. He added that the coalition does not plan to lobby for an "exact dollar amount."

He said, "We realize that it's going to take a nice sizable increase" (Reichard, CQ HealthBeat, 9/25).

William Hubbard, a former FDA associate commissioner and an advisor to the coalition, said that doubling FDA's current $1.5 billion budget would pay for itself if it led to life-saving drugs being approved one year sooner or averted a public health incident such as the recent E. coli cases linked to contaminated spinach (Boston Globe, 9/26).

CSPI Executive Vice President Michael Jacobson said FDA's "food division is particularly vulnerable to budget cuts because it is not bolstered by user fee laws." Jacobson said that the increasingly complex food products on the market "have stretched [FDA's] staff beyond the breaking point" (CQ HealthBeat, 9/25).

 

"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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