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Medicare Drug Program News
Democrats Say New Medicare Handbook is Misleading on
Drug Program
Democrats also release study showing benefits to senior citizens of
their proposals
October 27, 2006 – The Medicare drug program has been increasingly an issue as the Congressional
elections near. The latest is a controversy over the new Medicare
handbook, which Democrats say promotes the cost savings of Medicare
Advantage plans compared with traditional Medicare, but fails to inform
senior citizens that the plans can require higher out-of-pocket costs.
They also claim in has misleading information on the ability of plans to
change the drugs they cover. The Democrats also released a study showing
their recommendations for the drug program will save seniors $500
annually and eliminate the "donut hole" coverage gap.
 Democrats
Say Medicare Handbook Could Be Misleading for Beneficiaries Choosing
2007 Coverage Options, According to Letter Sent to HHS Secretary Leavitt
Senate and House Democrats this week in a letter to
HHS Secretary Mike Leavitt said that the Bush administration has
used a Medicare handbook on coverage options for beneficiaries to
promote Medicare Advantage plans, rather than to provide objective
information,
CQ HealthBeat reports.
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The letter -- signed by Sens. Max Baucus (D-Mont.)
and Jay Rockefeller (D-W.Va.) and Reps. Sherrod Brown (D-Ohio), John
Dingell (D-Mich.), Charles Rangel (D-N.Y.) and Pete Stark (D-Calif.) --
states that the handbook, which the administration has mailed to 43
million beneficiaries, promotes the cost savings associated with MA
plans compared with traditional Medicare but fails to inform
beneficiaries that the plans can require higher out-of-pocket costs.
According to the letter, a recent
Commonwealth Fund study "found that some MA plans charge as much as
$300 per day for hospital care and $5,600 for cancer chemotherapy."
The letter adds, "For beneficiaries in poorer
health who get admitted to a hospital several times a year or need
cancer care, MA costs could be far higher" than traditional Medicare.
The letter also suggests that the handbook implies
that changes in Medicare prescription drug plan formularies can occur
only "as a result of changes in drug therapies or as new medical
knowledge becomes available," CQ HealthBeat reports.
However, according to the letter, Medicare
prescription drug plans "can and do change their formularies for
business and other reasons, and beneficiaries should know this."
Although it is too late to change the handbook, according to CQ
HealthBeat, the letter adds that "equally biased and problematic"
language on the Medicare Web site "could be corrected virtually
overnight."
Reaction
CMS officials on Thursday in a statement said that they used
recommendations from various groups -- such as outside organizations
that help Medicare beneficiaries enroll in prescription drug plans -- to
prepare the handbook "in a clear, comprehensive and objective manner."
HHS spokesperson Christina Pearson said that
"throughout this process, we've sought and incorporated input from those
outside the department and are always willing to consider constructive
suggestions."
She added that the criticism of the handbook from
Democratic lawmakers "runs counter to the comments we've received from
hundreds of beneficiaries, organizations and officials" (Reichard, CQ
HealthBeat, 10/26).
Democratic Rx Drug Benefit Proposals
In related news, a report compiled by the Democratic staff of the
House Government Reform Committee has found that Democratic
proposals to revise the Medicare prescription drug benefit would save
the average beneficiary $500 annually and would eliminate coverage gaps
without an increase in cost for the federal government, CQ HealthBeat
reports.
According to the report, a Democratic proposal to
allow Medicare to negotiate directly with pharmaceutical companies for
discounts on medications would save almost 14 million beneficiaries more
than $60 billion in premiums, copayments and other out-of-pocket costs.
Democratic proposals also would allow six million
Medicare beneficiaries to avoid the so-called "doughnut-hole" coverage
gap in which beneficiaries are responsible for 100% of annual
prescription drug costs between $2,250 and $5,100, the report found. In
addition, more than one million Medicare beneficiaries would avoid
hundreds of dollars in late enrollment penalties under Democratic
proposals, according to the report.
Pearson said that Medicare beneficiaries currently
save an average of $1,100 on their annual medication costs under the
prescription drug benefit. In addition, she said that the
Congressional Budget Office and CMS actuaries have determined that
the proposal to allow Medicare to negotiate directly with pharmaceutical
companies for discounts on medications would not reduce costs for
beneficiaries.
Pearson also said that about 70% of Medicare
beneficiaries with drug coverage currently are enrolled in prescription
plans with no coverage gap and that about six million low-income
beneficiaries pay no premiums for their plans (CQ HealthBeat, 10/26).
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