Insurers Roll Out Premium Hikes for Medicare Rx Plans
With the Medicare drug benefit open enrollment period beginning on Nov. 15, health advocates are warning that beneficiaries could be faced with premium increases and formularies that might not include drugs they need, according to the San Francisco Chronicle.
The Chronicle reports that about 75% of beneficiaries nationwide will see premium increases if they keep their current drug plan. In addition, millions of low-income beneficiaries and those with disabilities who are dually eligible for Medicare and Medicaid could be switched automatically to new drug plans in 2008 that "may or may not cover their drugs," the Chronicle reports.
Medicare beneficiaries in California will see monthly premiums for traditional Medicare drug plans increase by 24% on average, but beneficiaries who do not switch out of the plans they currently have could see higher premium increases.
Chris Perrone, senior program officer for the California HealthCare Foundation, estimates that premiums will go up by 31% on average for California Medicare beneficiaries who do not move into new plans.
Fifty-six stand-alone drug plans are available in California, and 180 Medicare health plans also are available. The freestanding plans are available statewide, but some Medicare health plans have more limited availability (Colliver, San Francisco Chronicle, 11/8).
CHCF publishes California Healthline.
WellPoint, UnitedHealth Group, Humana and other insurers that offer Medicare drug plans should have returned about $4.4 billion in 2006 overpayments faster, according to a report released on Tuesday by HHS Inspector General Daniel Levinson, Bloomberg/Indianapolis Star reports.
According to the report, CMS "has no mechanism in place to identify situations in which prospective payments differ significantly from sponsors' actual costs or to adjust prospective payments accordingly to avoid large discrepancies at the end of the year."
House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.), who is leading efforts to reduce the program's reliance on private insurers, said the insurers that owe refunds are getting "multibillion-dollar, zero-interest loans from Medicare."
In a written response, acting CMS Administrator Kerry Weems said the overpayments are the result of drugs costing less than anticipated, and future estimated payments likely will be more accurate (Bloomberg/Indianapolis Star, 11/8).