MASSACHUSETTS: Harvard Pilgrim Drops Unlimited Rx Coverage
In a move that angered seniors' advocates and politicians alike, Harvard Pilgrim Health Care yesterday announced that beginning in 1999 it will no longer offer unlimited prescription drug benefits to enrollees in its First Seniority Medicare HMO for financial reasons. The Boston Globe reports that the announcement "caps months of arduous negotiations by advocates, politicians and HMOs in the state to resolve a looming crisis for seniors come Jan. 1, when the state's Medicare HMOs are planning to cap the amount they will reimburse for drugs." In an effort to ease the financial burden on seniors, Harvard Pilgrim said it would establish a "program to help low-income seniors purchase needed medicine," and will release further details "in coming weeks." According to the Globe, Harvard Pilgrim's move paves the way for other HMOs in the state to "proceed with their original plans" to cap the drug coverage. Both Fallon Community Health Program and Blue Cross and Blue Shield of Massachusetts "said they would also cap benefits," and Tufts Health Plan "said it would make an announcement on its drug benefits today" (Pham, 11/17). Voicing his disappointment, acting Gov. Paul Cellucci (R) said, "We're going to continue to push Congress to amend the law. ... I think the feds should step out of the way and let us enforce our own law" (Finucane, AP/Boston Globe, 11/17). Barbara Anthony, chief of the public protection bureau at the state attorney general's office, said, "It's regrettable that Harvard Pilgrim has decided to balance its budget on the backs of seniors" (Globe, 11/17).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.