CMS Announces New Rules for Enrollment in Medicare Prescription Drug Discount Card Program
States that already have prescription drug assistance programs for low-income Medicare beneficiaries will be allowed to automatically enroll them in the Medicare prescription drug discount card program when it begins this spring, CMS Administrator Mark McClellan announced Saturday, the AP/Akron Beacon Journal reports (Sherman, AP/Akron Beacon Journal, 4/18). As part of the new Medicare law, prescription drug discount cards will be available beginning in May to all beneficiaries who do not have prescription drug coverage through Medicaid. The cards could offer savings of about 10% to 25% on beneficiaries' prescription drug costs until the new prescription drug benefit takes effect in 2006. Companies offering the cards can charge an annual enrollment fee of up to $30 and likely will offer savings on at least one drug in each of 209 categories of medicines commonly used by Medicare beneficiaries. HHS in March approved 28 private companies to offer 49 different discount cards to Medicare beneficiaries. Beneficiaries with annual incomes less than $12,569 per year for individuals or $16,862 for couples will be eligible for a $600 annual subsidy for their prescription drug costs and will not have to pay any enrollment fees (California Healthline, 4/14). Speaking at the joint conference of the American Society on Aging and the National Council on Aging in San Francisco, McClellan said that the government would also require the 28 companies offering the discount cards to use a standard enrollment form to ease the process of signing up seniors (Wolfe, Minneapolis Star Tribune, 4/18). The form will be available on the Medicare Web site (AP/Akron Beacon Journal, 4/18).
McClellan said, "We've gotten to the point where many Americans feel like they have to choose between safety and effectiveness and affordability by skipping needed doses, by cutting pills or purchasing unproven drugs" (San Francisco Chronicle, 4/18). He added, "This is a very significant program, and we think these changes will help make them more effective" (Minneapolis Star Tribune, 4/18). McClellan said, "We intend to make it as easy as possible for Medicare beneficiaries to get the information they need and to enroll in the drug card program." State officials and consumer advocates have said that adopting the uniform enrollment form and automatically enrolling some seniors would "significantly increase the number of seniors who would receive the $600-a-year subsidy," the AP/Beacon Journal reports (AP/Akron Beacon Journal, 4/18). James Varpness, head of aging and adult services at the Minnesota Department of Human Services, expressed concern about the automatic enrollment provision, saying, "Everybody's needs are different. And because this is a voluntary program, everyone must be given a chance to say no before we could sign them up. This change may have just made the already complicated drug discount card program even more complicated" (Minneapolis Star Tribune, 4/18).
Several other newspapers recently examined the potential impact of the new Medicare law and the prescription drug discount card program. Summaries of the articles appear below.
Baltimore Sun: The Sun on Saturday examined the "extraordinarily complicated" drug discount card program and experts' fears that the complexities of the enrollment process could prevent many low-income beneficiaries from participating. According to Bruce Stuart, executive director of the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland, the government's projections that 4.7 million low-income beneficiaries will sign up for the drug card program is optimistic. The Sun also provides a question and answer feature on the new card (Zaneski, Baltimore Sun, 4/17).
New York Times: The Times on Sunday examined reaction to new law among beneficiaries in Arizona, as well as efforts by Rep. Rick Renzi (R-Ariz.), who voted for the bill, to address beneficiaries' concerns. After interviewing Arizona Medicare beneficiaries, the Times determined that many beneficiaries have only "sketchy knowledge" of the new law and that those who are "intimately familiar" with it are "often skeptical" it will help them. The Times reports that Renzi's situation is "typical," as many members of Congress who voted for the bill are finding themselves "on the defensive" in trying to explain the law's provisions and "respond to a barrage of Democratic criticism" (Pear, New York Times, 4/18).
- San Jose Mercury News: The Mercury News on Monday examined some of the potential problems with the drug discount card program. According to the Mercury News, many beneficiaries will find the discounts "a bit anemic," especially because the cards might not cover all medications and some beneficiaries might be ineligible to participate. Diane Archer of the Medicare Rights Center said the program "could be very valuable" for low-income seniors, but for "other people with Medicare, the jury's out" (Feder Ostrov, San Jose Mercury News, 4/19).