AARP Calls for Revisions to 2003 Medicare Law
Congress should revise the 2003 Medicare law to allow HHS to negotiate prices with pharmaceutical companies and revise income criteria for subsidies offered under the drug benefit, Bill Novelli, CEO of AARP, said on Friday in an overview of the group's legislative agenda for 2006, CQ HealthBeat reports (Reichard, CQ HealthBeat, 1/27).
Novelli said AARP in 2006 would work to eliminate "barriers" to the Medicare drug benefit, including criteria for determining eligibility for low-income subsidies (Heil, CongressDaily, 1/27).
John Rother, policy director at AARP, said the group would support legislation that would eliminate the inclusion of assets, such as real estate, in determining whether beneficiaries qualify for the subsidies (Goldstein, Washington Post, 1/28). AARP also might support legislation that would take steps to increase enrollment in the drug benefit, Rother said. "We'll be in a better position to make recommendations to Congress once we have more experience" with the Medicare prescription drug benefit (CongressDaily, 1/27).
In addition, AARP will "work hard" in 2006 to push for legislation that would allow the "safe and legal" reimportation of prescription drugs, according to a statement released by the group. AARP also opposes cuts to Medicare and Medicaid funding, the group said.
According to the statement, "Just cutting benefits and services instead of attacking escalating health care costs will only make things worse" (CQ HealthBeat, 1/27).
Novelli said, "[C]hopping away at Medicaid and Medicare does not address the real problem -- escalating heath care costs, which now account for 16%" of the gross domestic product (AARP release, 1/27). Novelli said businesses and the government increasingly are shifting health and pension costs to employees, which reinforces the "great importance of Social Security, Medicare and Medicaid as the bedrock of our nation's retirement security."
AARP also said it would support legislation promoting the adoption of health information technology. It also would support an increase in publicly available information on the costs of drugs and diagnostic care and prices charged by physicians and hospitals.
In addition, the group said, legislation should promote reliance by health care providers on practices justified by medical literature and reward quality care through pay-for-performance policies. Further, according to AARP, Congress should pass legislation that would increase home- and community-based care as an alternative to nursing homes (CQ HealthBeat, 1/27).
The group supports legislation by Reps. Nancy Johnson (R-Conn.) and Earl Pomeroy (D-N.D.) that would provide tax credits to individuals who provide long-term care for family members, according to CongressDaily (CongressDaily, 1/27). Congress also should pass legislation lessening restrictions on charitable giving and asset transfers prior to receiving Medicaid coverage for nursing home care, AARP said (CQ HealthBeat, 1/27).
In other Medicare news, nearly two million beneficiaries who are dually eligible for Medicaid and Medicare were enrolled in drug plans that do not cover many commonly prescribed medications, according to a report released Friday by the HHS Office of the Inspector General, the Chicago Tribune reports. Under the drug benefit, nearly all dual eligibles -- who received drug coverage through state Medicaid programs before the drug benefit took effect -- were automatically enrolled in Medicare drug plans by the federal government.
According to the OIG report, 18% of dual eligibles were enrolled in plans that covered all commonly prescribed medications, while 30% were enrolled in plans that do not cover at least 15% of commonly prescribed drugs. In total, drug plans cover an average of 92% of the 178 medications most commonly prescribed to dual eligibles, according to the report.
CMS officials said the report's methodology is flawed and its results are inaccurate.
CMS spokesperson Gary Karr said, "All Medicare drug plans have to cover all medically necessary treatments." Karr said a beneficiary who takes a medication that is not on a drug plan's formulary can have a physician prescribe a covered drug in the same category.
Sen. Jeff Bingaman (D-N.M.) said in a statement, "Our nation's most vulnerable, low-income citizens are actually worse off under the new Medicare drug benefit than they were under Medicaid" (Graham, Chicago Tribune, 1/28).
The report is available online. Note: You must have Adobe Acrobat Reader to view the report.
In other Medicare news, Rep. Henry Waxman (D-Calif.), senior Democrat on the House Government Reform Committee, on Saturday said that Congress should pass legislation to change the 2003 Medicare law, the AP/Boston Herald reports. Speaking in the Democrats' weekly radio address, Waxman said the changes should use "the purchasing power of all of America's seniors to get low prices and better coverage."
According to Waxman, "corruption, incompetence and an ideology that favors private profits over public programs all played a role" in the passage of the 2003 Medicare law. He added, "The program was turned over to hundreds of private insurers who can charge what they want, cover what drugs they want and change what they cover at will. Instead of the certainty of Medicare coverage, seniors are now faced with a confusing array of choices, inaccurate information and sometimes even higher costs."
Waxman said he had "never seen a more dishonest legislative process than the one used to pass" the bill (AP/Boston Herald, 1/28).
On Friday, Waxman sent a letter to the Government Accountability Office urging an investigation into whether drug prices under the drug benefit are higher than prices paid by state Medicaid programs. Citing research by a professor at the University of Minnesota, Waxman said it appears Medicare drug prices are 20% to 30% "above Medicaid prices."
Ken Johnson, senior vice president at Pharmaceutical Research and Manufacturers of America, said Waxman's letter is "full of distortions and errors" (Chicago Tribune, 1/28).
Los Angeles Times: The Times on Monday examined how some beneficiaries are purchasing prescription drugs from Canada instead of enrolling in the Medicare drug benefit. According to the Times, such seniors "are not bothered by the idea of relying on prescriptions filled by foreign pharmacists," and "some say they prefer the ease of shopping by mail over schlepping to the drugstore" (Girion, Los Angeles Times, 1/30).
Los Angeles Times: The Times on Monday examined outreach efforts by My Medicare Matters, a collaboration of "governmental agencies, church groups and organizations for the elderly" that assists beneficiaries with the drug benefit (Hernandez, Los Angeles Times, 1/30).
Orlando Sentinel: The Sentinel on Sunday examined how "drug expenses will increase this year" under the drug benefit for "millions of seniors and disabled nationwide," even though the program was "billed as a money-saver." Officials at insurance companies offering Medicare drug plans say most beneficiaries will save under the drug benefit, but some beneficiaries say their costs were less before the program took effect, the Sentinel reports (Shelton, Orlando Sentinel, 1/29).
Richmond Times-Dispatch: The Times-Dispatch on Monday examined how the 25 aging agencies in Virginia "are turning to volunteers" to assist beneficiaries who are "baffled" by the drug benefit. The agencies have added volunteers to staff phone lines or assist beneficiaries at clinics (Booker, Richmond Times-Dispatch, 1/30).
- Sacramento Bee: The Bee on Saturday examined how some Medicare drug plans require physicians to receive prior authorization before prescribing some medications. According to the Bee, some physicians say they have become "overwhelmed by the red tape standing between them and their chronically ill seniors and disabled patients, causing delays for all patients to ripple through their practices" (Weaver Teichert, Sacramento Bee, 1/28).