|
E-mail this page to a friend!
Medicare Drug Program News
CMS Urged to Act Now to Avoid Chaos at the Pharmacy
for Low-Income Seniors
Medicare Rights Center wants to avoid medication
treatment interruption
November 28, 2006 - About 288,000 low-income older
and disabled Americans will be reassigned to new Medicare private drug
plans beginning January 1, 2007, because their current drug plan’s
premium is too high to qualify for full “Extra Help,” the federal
subsidy which helps low-income people pay for Medicare drug coverage,
according to the Medicare Rights Center. MRC is calling on the Centers
for Medicare & Medicaid Services to act now to "avert a crisis" for
these and other low-income beneficiaries facing steep increases and
abrupt changes in drug coverage in the new year.
| |
Related Stories |
|
| |
Wal-Mart $4 Generic Drug Program Available in all
U.S. Stores Tomorrow
Company releases
complete drug list, including new additions
November 27, 2006 – Tomorrow the Wal-Mart program
offering a month's supply of generic drugs for $4 will be available in
all of its 3810 pharmacies across the U.S. In today's announcement,
Wal-Mart also expanded the program to include 331 generic prescriptions,
including 14 of the top 20 prescribed medications listed by www.rxlist.com. The list is made up of as many as 143 compounds in 26
therapeutic categories. (See complete list below story.)
Read
more...
CMS Says 16,000 Enrolled in Medicare Part D Online
in First 24 Hours
Medicare adds new online tool to see performance of
the plans
November 17, 2006 – Yesterday, on the first active
day of the Medicare open enrollment period, the Centers for Medicare &
Medicaid Services added a new consumer tool to its Website focusing on
plan performance. At the Medicare Part D Plan Performance metrics for
2006, senior citizens are able to see how plans are rated along with
specific data on how they performed on the following areas of customer
service, including: telephone customer service, complaints, appeals, and
sharing information with pharmacists.
Read more...
Read more
on
Medicare Drug Program
or
Medicare
|
|
“Last year CMS failed to heed repeated warnings
about the problems expected when poor people’s drug coverage is
interrupted,” said Robert M. Hayes, president of the Medicare Rights
Center, a national consumer service organization. “Thousands of
Americans were denied their medicine and 37 state governments were
forced to launch emergency rescue programs.”
“There is still time for CMS to avoid another
fiasco and ensure that no one suffers the dire consequences of disrupted
medication regimes again this year,” said Mr. Hayes.
The reassignment will impact people with Medicare
in 40 states and will be done without regard to whether the new plan
covers the drugs on an individual’s medication regimen, according to a
new Medicare Rights Center report “Part D 2007: Addressing Access
Problems for Low-Income People with Medicare.”
Additionally, hundreds of thousands of low-income
people with Medicare will be reassigned to new plans offered by the same
private drug plan insurance company with no guarantees that their
medicines will still be covered.
To help ensure that low-income people with Medicare
will be able to get their medications in the New Year, the Medicare
Rights Center has made the following recommendations in its report:
1. use formulary criteria to guide
“intelligent” reassignment;
2. require Part D plans to exempt from formulary restrictions
any drug regimens covered under the individual’s assigned plan in 2006;
3. mandate that Part D plans carry over into 2007 all
exceptions and prior authorization requests granted in 2006, whether
granted by them or by another Part D plan;
4. extend a Special Enrollment Period to all people with Extra
Help, whether or not they will be reassigned to a new plan in 2007, or
end the private plan lock-in instituted in 2006;
5. guarantee that the federal government will reimburse states
(and recoup costs from private insurers) when states use the Medicaid
program as a fall-back option for people with Medicare and Medicaid when
coverage is wrongly denied through the Part D plan.
An additional 630,000 people eligible for Extra
Help this year will be dropped from the federal subsidy program in
2007. Most of these poor older and disabled Americans still qualify for
the subsidy but are no longer listed on the Medicaid enrollment files
which triggers automatic enrollment in Extra Help.
“Most older and disabled Americans won’t know they
lost the subsidy until they go to the pharmacy,” said Mr. Hayes. “They
will be required to pay full price to meet the deductible and many will
leave empty handed.”
The Medicare Rights Center has urged CMS to take
immediate action and require that all Part D plans implement a
transitional “safety net” for individuals dropped from Extra Help, until
they have been successfully reenrolled. It can take at least three to
four weeks to be approved for Extra Help after an application has been
submitted.
Editor's Notes:
“Part
D 2007: Addressing Access Problems for Low Income People with Medicare”
is available on the Medicare Rights Center’s website.
Medicare Rights Center (MRC) claims to be the
largest independent source of Medicare information and assistance in the
United States. Founded in 1989, MRC helps older adults and people with
disabilities get high-quality, affordable health care.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
