Implementation of Medicare Prescription Drug Benefit Will Be Difficult, MedPAC Says
CMS will have difficulty educating Medicare beneficiaries about the new drug benefit, as "[f]ederal, state and private outreach proved relatively ineffective" in enrolling beneficiaries in the temporary Medicare drug discount card program, according to the Medicare Payment Advisory Commission's June report to Congress, CQ HealthBeat reports. The report notes that a "large share" of overall enrollment in that program is because of automatic enrollment of people enrolled in state-sponsored and Medicare Advantage plans, CQ HealthBeat reports.
The report also says that appeals rights will become more important, as many Medicare beneficiaries transfer from the traditional, fee-for-service program to private Medicare plans. MedPAC also recommends that the HHS secretary develop a plan to deliver CMS-collected data on the drug benefit to Congress to keep lawmakers informed about the benefit's cost, quality and access issues. The report also suggests that Congress establish larger regions for Medicare Advantage plans to stabilize payment rates and create private-sector marketing areas that "accurately reflect existing health care markets," according to CQ HealthBeat.
MedPAC also restates its support for "payment equality" between private plans and fee-for-service Medicare and recommends steps to achieve those goals, including the elimination of a $10 billion "stabilization fund" for private health plans. The report also recommends removing the effect of payments for indirect medical education from the Medicare Advantage plan benchmarks to save Medicare $200 million to $600 million within one year and $1 billion to $5 billion in five years (CQ HealthBeat, 6/20).
HHS Secretary Mike Leavitt on Monday visited Florida -- the first stop on a nationwide tour -- to promote the new Medicare prescription drug benefit, the South Florida Sun-Sentinel reports (Lade, South Florida Sun-Sentinel, 6/21).
More than 12 private insurers are expected to be chosen before Oct. 1 to offer Medicare prescription drug plans (Fantz, Miami Herald, 6/21). At that time, Leavitt said, "The job of seniors will be to find out about them and figure out which one is the best for them."
HHS has allocated $300 million this year to publicize the benefit and educate consumers. Details about the plans could be available later this summer (South Florida Sun-Sentinel, 6/21).
The Sacramento Bee on Monday examined the enrollment process for the new prescription drug benefit.
Robert Hayes, president of the Medicare Rights Center, said enrollment will present elderly and disabled beneficiaries with "a bewildering range of options that will cause anxiety and a significant risk of exploitation and intimidation."
However, CMS spokesperson Gary Karr said selecting a provider will be "a lot easier than it seems," adding, "Most seniors will not have to wade through a bewildering list of choices" (O'Rourke, Sacramento Bee, 6/20).
Additional information on the Medicare drug benefit is available online.