Issues Related to New Medicare Drug Benefit Examined
Several newspapers recently examined issues related to the new Medicare prescription drug benefit. Summaries appear below.
Christian Science Monitor: The Monitor on Thursday examined a little-publicized provision in the 2003 Medicare law under which the Agency for Healthcare Research and Quality will study the cost-effectiveness of medications offered under the new prescription drug benefit. Medications that "don't work well" or are "much more expensive than alternatives" will stand out, the Monitor reports. AHRQ will widely distribute the study results. After the prescription drug benefit begins on Jan. 1, 2006, Medicare will account directly for 28% of all prescription drug sales in the U.S., and the AHRQ study could have a "far-ranging, even revolutionary, effect on how drugs are judged for effectiveness and how they are priced," according to the Monitor (Lamb, Christian Science Monitor, 10/27).
CQ HealthBeat: Rep. Jim Cooper (D-Tenn.) and Sen. Tom Carper (D-Del.) have sent separate letters to CMS Administrator Mark McClellan over concerns that the Medicare.gov Web site and Medicare hotline, "touted" by agency officials as tools to help beneficiaries select prescription drug plans, are not "working properly," CQ HealthBeat reports. In his letter, Cooper wrote that telephone calls to the Medicare hotline involve long delays and that beneficiaries who have Internet access consider Medicare.gov "difficult to use and confusing." He also wrote that many Medicare beneficiaries are not aware that the prescription drug benefit is voluntary. In a separate letter, Carper wrote that the tool on Medicare.gov designed to help beneficiaries select prescription drug plans remains unavailable and that specific information on prices and medications formularies is not consistent. CMS spokesperson Gary Karr said that the letters "raise legitimate issues, many of which we are dealing with." He added that CMS will address problems with Medicare.gov before enrollment in the prescription drug benefit begins on Nov. 15 (CQ HealthBeat, 10/26).
- AP/St. Paul Pioneer Press: The Senate by voice vote on Wednesday approved an amendment that would require the federal government to send new information handbooks on the prescription drug benefit to Medicare beneficiaries because the original handbooks contained an error (Frommer, AP/St. Paul Pioneer Press, 10/27). The "Medicare and You" handbook, mailed earlier this month, erroneously states that low-income beneficiaries who enroll in any prescription drug plan available in their area will not have to pay premiums. However, only about 40% of prescription plans will require no premiums (California Healthline, 10/6). Sen. Mark Dayton (D-Minn.), who sponsored the amendment, called the error "critical." He added that efforts by CMS officials to correct the error on the agency Web site and through conversations on the Medicare hotline are not adequate because many beneficiaries will not visit the Web site or call the hotline. Karr estimated that CMS would have to spend an additional $50 million to send new handbooks to all Medicare beneficiaries and that prescription drug plan sponsors must inform low-income beneficiaries that they qualify for coverage without premiums (AP/St. Paul Pioneer Press, 10/27).