Democrats Offer Bills on Medicare Drug Benefit
Sens. Max Baucus (D-Mont.), ranking member on the Senate Finance Committee, and Blanche Lincoln (D-Ark.), also a member of the committee, proposed two bills on Thursday that they said would simplify the Medicare prescription drug benefit, CQ HealthBeat reports.
One bill would create six defined types of drug plans with the aim of easing the comparison process for beneficiaries. In addition, the bill would prohibit drug plans from making changes to their formularies during the plan year and require plans to submit quality and appeals data, which would be available to beneficiaries.
A second bill would require drug plans to reimburse pharmacies more quickly and establish hotlines for pharmacists. Some pharmacists have said slow reimbursements have disrupted their cash flow and forced them to borrow money to remain in business. The second bill also would prohibit marketing practices that could mislead beneficiaries about which pharmacies are in a plan's network.
Baucus said the implementation of the drug benefit "has been skewed way too much toward insurers," adding, "We want pharmacists to be treated like partners, not piggybanks."
CMS spokesperson Peter Ashkenaz said the agency is "busy taking action now" to help beneficiaries enroll and is working to resolve pharmacists' concerns "as quickly as they are raised" (Carey, CQ HealthBeat, 4/27).
In the House, Rep. Jeb Bradley (R-N.H.) has proposed a bill that would extend to Dec. 31 the deadline for enrolling in the drug benefit without incurring a financial penalty, the AP/Manchester Union Leader reports. The current deadline to enroll without penalty is May 15.
Bradley said beneficiaries should be given additional time to enroll because of confusion and problems with the implementation of the drug benefit.
Brian Cresta, regional director of CMS, said the Bush administration does not support a deadline extension because it has met its enrollment goal (AP/Manchester Union Leader, 4/28).
CMS Administrator Mark McClellan on Thursday said the Bush administration will not tolerate drug plans that mislead beneficiaries or act fraudulently, the San Antonio Express-News reports. McClellan, who was visiting several cities in Texas as part of a nationwide bus tour to promote the drug benefit, said CMS has received a few complaints about drug plans that have provided beneficiaries with misleading information. He added that the agency generally has been able to address problems through enforcement letters (Poling, San Antonio Express-News, 4/27).
Two publications featured news on the new formulary policy announced by the Bush administration on Wednesday that requires insurers sponsoring Medicare drug plans to allow enrolled beneficiaries to continue receiving coverage for medications, even if the company drops the drugs from its formulary (California Healthline, 4/27). Summaries appear below.
CongressDaily: Sen. Olympia Snowe (R-Maine), who had proposed legislation similar to the new formulary policy, said she is pleased with the change but noted that it does not have the force of law, CongressDaily reports (Marshall-Genzer/Heil, CongressDaily, 4/28).
- Los Angeles Times: The new policy addresses concerns raised by some congressional Republicans and Democrats who said the previous rules were unfair because drug plans could change their formularies as often as they liked but beneficiaries could only change plans once annually, the Times reports (Los Angeles Times, 4/28).
NPR's "Morning Edition" reported on the change to the Medicare prescription drug benefit. The segment includes comments from Baucus and Lincoln and CMS Deputy Administrator Leslie Norwalk (Rovner, "Morning Edition," NPR, 4/28).
The complete segment is available online in RealPlayer.