Legislators Propose Modifications To Medicare Drug Benefit
Sen. Carl Levin (D-Mich.) on Monday said that he will propose revisions to the Medicare prescription drug benefit, the Detroit Free Press reports. According to Levin, Medicare prescription drug plan sponsors should have the ability to revise formularies only during the open enrollment period and only one time annually.
In addition, Levin said that he will propose to:
- Eliminate prescription drug copayments for beneficiaries who are dually eligible for Medicaid and Medicare;
- Increase assistance to Medicare beneficiaries who previously received medications through assistance programs administered by pharmaceutical companies; and
- Eliminate the so-called "doughnut hole," a coverage gap under which Medicare beneficiaries must pay 100% of prescription drug costs.
Meanwhile, Rep. Rahm Emanuel (D-Ill.) said the federal government should issue low-income and disabled Medicare beneficiaries $1,000 debit cards for the purchase of prescription drugs. In addition, Emanuel said he plans to introduce legislation that would reimburse states that have taken steps to ensure access to medications for Medicare beneficiaries under the prescription drug benefit (O'Donnell, Chicago Sun-Times, 1/24).
Two newspapers on Tuesday examined issues related to Medicare. Summaries appear below.
Chicago Tribune: The Tribune examined how the Medicare prescription drug benefit has affected care for nursing home residents, many of whom are dual eligibles. According to the Tribune, some Medicare prescription drug plans have rejected claims for dementia medications, antidepressants and intravenous treatments that prevent dehydration or treat infections. CMS on Tuesday plans to hold a two-hour conference call with Medicare prescription drug plans and pharmacists to address issues related to coverage of intravenous medications (Graham, Chicago Tribune, 1/24).
- Washington Post: The Post examined how House and Senate Republican conferees last month met "behind closed doors" to eliminate a provision in the Senate version of the budget reconciliation bill that would have reduced reimbursements to HMOs by $26 billion over the next ten years, according to the Congressional Budget Office. "House and Senate Democrats were excluded from the meeting," which resulted in legislation that would eliminate "all but $4 billion of the projected savings" to Medicare and "save the health insurance industry $22 billion" over ten years, the Post reports. According to the Post, the meeting demonstrates how "Republican congressional lawmakers and leaders are making vital decisions, involving far-reaching policies and billion of dollars, without the public -- or even congressional Democrats -- present" (Weisman, Washington Post, 1/24).