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Medicare Drug Program News
Concern Grows that Low-Income Senior May Have
Problems with Medicare Drugs
VA denies HHS claim
that vets prefer Medicare drug program
December 5, 2006 Concern that low-income senior
citizens will have trouble getting their medications next month, as they
did in January of this year, is being voiced by pharmacists and advocacy
groups, according to today's KaiserNetwork.org's daily report. It also
reports that the Department of Veteran Affairs denies reports by Health &
Human Services that veterans are leaving its program to sign up for drug
coverage through Medicare.
 Pharmacists, Advocates Raise Concerns About
Potential Prescription Drug Access Issues for Low-Income Medicare
Beneficiaries
Some pharmacists and advocates have raised concerns
that many low-income Medicare beneficiaries "will again have trouble
getting medications next month, as they did in January of this year,"
when the Medicare prescription drug benefit began, the
New York Times reports.
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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 plans
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.
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About 600,000 low-income Medicare
beneficiaries who automatically received a
subsidy to help cover their prescription drug costs this year will
have to apply on their own to qualify for the funds for the 2007 plan
year, which begins Jan. 1, 2007.
According to the Times, some
pharmacists and advocates have raised concerns that many of the affected
Medicare beneficiaries "will not discover the change in their status
until they show up at pharmacies next month" and are charged higher
copayments.
Medicare beneficiaries have until Dec. 31 to enroll in the
prescription drug benefit or make changes to their plans.
This year,
several states established emergency programs to help Medicare
beneficiaries who had problems with access to medications under the
prescription drug benefit because of enrollment or other issues, but
most states have ended those programs.
Stan Rosenstein -- the Medicaid
director in California, which will continue such an emergency program
until Jan. 31, 2007 -- said, "We anticipated that there could be
problems in January. So we kept the program available as a safety net."
CMS officials said that they have taken steps to avoid the problems
with the Medicare prescription drug benefit that occurred last January.
CMS spokesperson Kathleen Harrington said, "Lessons have been learned."
Mark Gregory -- a vice president for
Kerr Drug, which owns 102 pharmacies in North Carolina and South
Carolina -- said, "It can't be as bad as early this year. Some seniors
will show up at the pharmacy, unaware they have been reassigned to a
different plan" (Pear, New York Times, 12/5).
Additional Coverage
Two newspapers recently examined issues related to
the ongoing open enrollment period for the Medicare prescription drug
benefit. Summaries appear below.
●
Reuters: Reuters examined revisions to Medicare prescription drug
plans for 2007. According to Reuters, while the government says monthly
premiums will average around $24 is 2007, "many plans are making big
price changes and dropping some covered prescriptions" (Dixon, Reuters,
12/3).
● Wall Street Journal: The Journal examined a new
tool on the Medicare Web site that allows beneficiaries to estimate
their monthly and annual spending and determine whether or when they
will reach the so-called "doughnut hole" coverage gap (Zhang, Wall
Street Journal, 12/5).
VA 'Defections'?
In related news, CMS officials have promoted the
Medicare prescription drug benefit by "pointing to defections" from a
Department of Veterans Affairs program, but VA officials report "no
signs, large or small, of folks leaving," the
AP/Spokane Spokesman-Review reports.
HHS Secretary Mike Leavitt recently said that "about a third of
those who are on the Veterans Administration plan chose to enroll in a
Part D plan."
CMS spokesperson Jeff Nelligan said that almost 1.8
million veterans who previously enrolled in the VA program are enrolled
in a Medicare prescription drug plan or receive coverage through their
former employers, which receive tax breaks to provide the coverage to
retirees eligible for Medicare.
However, Mike Valentino, pharmacy
director for the VA, said, "I've seen some of those comments about a
million veterans leaving VA for Part D. Our data doesn't support that."
Valentino said that about 4.3 million veterans received prescriptions
through the VA program this year, compared with 4.1 million in 2005.
According to the AP/Spokesman Review, the comments might indicate that
almost two million veterans "are enrolled in both programs" (Freking,
AP/Spokane Spokesman-Review, 12/5).
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