Calif. Representative Calls for Repeal of 2003 Medicare Law
Rep. Dennis Cardoza (D-Calif.) on Wednesday said Congress should repeal the 2003 Medicare law and draft new legislation to replace it, the Stockton Record reports. Cardoza voted against the 2003 legislation.
Cardoza said that the deadline to enroll in a Medicare prescription drug plan without a penalty should be extended from May 15 to the end of the year and that the "doughnut hole" -- the break in drug coverage between about $2,500 and $5,000 in annual expenses -- should be eliminated.
In addition, Cardoza said he would deliver petitions signed by several hundred Stockton residents to the administration of President Bush. The petitions call for immediate modifications to the drug benefit (Goldeen, Stockton Record, 2/23).
Independent pharmacists in California say the Medicare drug benefit has been "particularly troublesome for them" because they have fewer resources than chain pharmacies to handle problems, the Sacramento Bee reports.
Independent pharmacists say that they have to devote more time and manpower to explaining the benefit and that information on Medicare prescription drug plans is often unavailable or difficult to obtain. In addition, reimbursements from private insurers take longer to arrive than Medi-Cal reimbursements, and payments sometimes are less than the cost of the drug (Le, Sacramento Bee, 2/22).
For example, the owner of two pharmacies in San Bernardino estimates that his pharmacies filled at least 2,000 fewer prescriptions in January, 75% of which he attributed to issues with the Medicare drug benefit, including his decision not to participate in some local prescription drug plans because of low reimbursement rates (Martin Tucker, Business Press, 2/22).
Jeff Flick, a regional administrator with CMS in San Francisco, said market forces eventually will "self-correc[t]" and pharmacies will receive reimbursements they consider adequate.
But Carol Cooke, a spokesperson for the National Community Pharmacists Association, said independent "pharmacy owners are small business owners and entrepreneurs who can't weather the prices" (Le, Sacramento Bee, 2/22).
Federal officials recently visited two California pharmacies to discuss recurring problems with the new Medicare drug benefit. Pharmacists have complained of getting inaccurate information about customers' copayments and enrollment status.
While pharmacists say there are fewer problems now than when the benefit was launched Jan. 1, there are new enrollment problems each month.
Stan Rosenstein, chief of Medi-Cal, said additional enrollment problems could occur if dual eligibles choose to switch plans on Feb. 25 because a drug plan might not recognize their dual-eligible status until March 10 (Weaver Teichert, Sacramento Bee, 2/21).
Members of the Coalition of Agencies Serving the Elderly earlier this month protested the Medicare drug benefit in San Francisco and called on the federal government to offer an alternative plan, the World Journal reports.
The coalition said the benefit was difficult to understand and offers too many different prescription drug plans. Protesters would like a more streamlined system.
The coalition also wants California to monitor the benefit to ensure that seniors are benefiting from the plan (Li, World Journal, 2/20).
Summaries of recent letters to the editor addressing the Medicare drug benefit appear below.
- Andrew Sperling, Los Angeles Times: CMS "has taken a number of steps to ensure that" people dually eligible for Medicare and Medi-Cal "do not face gaps in coverage for critically important prescriptions," Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness, writes. For example, drug plans are required to "cover all medications in this initial transition period" and plans must "cover all drugs to treat conditions such as mental illness and epilepsy," according to Sperling (Sperling, Los Angeles Times, 2/22).
- Stanley Goldenberg/William Powers, Los Angeles Times: "Corrective action" on the Medicare prescription drug plan "should come soon," according to a letter to the editor by Stanley Goldenberg and William Powers, president and vice president of the California Board of Pharmacy, respectively. Goldenberg and Powers "call on Congress to make significant changes" to the program, "which is much too complex and too heavily weighted to the benefit of the plans and pharmaceutical firms" (Goldenberg/Powers, Los Angeles Times, 2/22).
Additional information on the Medicare drug benefit is available online. This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.