McClellan Addresses Lawmakers’ Concerns About Medicare Prescription Drug Benefit
CMS Administrator Mark McClellan addressed lawmakers' questions about the new Medicare prescription drug benefit on Tuesday at a Senate Homeland Security and Governmental Affairs Committee hearing, the Knight Ridder/St. Paul Pioneer Press reports. A summary of his testimony appears below.
- Video News Releases: McClellan addressed concerns about video news releases that CMS has used to educate Medicare beneficiaries about the new Medicare law. The Government Accountability Office has said such government-made releases might "violate a ban on government propaganda" because they fail to alert viewers that they are government communications, the Inquirer reports. In response, McClellan said he will not promise to ban use of such releases but will "fully comply with the law" (Pugh, Knight Ridder/St. Paul Pioneer Press, 4/5).
- Schedule: McClellan also informed lawmakers that CMS is on schedule to launch the new prescription drug benefit, noting that the agency has hired 345 new employees -- including a number with expertise in drug benefits, pharmacy services, disease management, retiree health benefits and contracts -- to manage the service expansion (Barr, Washington Post, 4/6). He noted that Medicare has tested its phone operators and found that they provide accurate information about the drug benefit to beneficiaries in 90% of calls (CQ HealthBeat , 4/5).
- Widespread Coverage: McClellan said that all areas of the country are expected to have at least two private drug plans competing to provide coverage (Knight Ridder/St. Paul Pioneer Press, 4/5). He said CMS has received more than 130 new Medicare Advantage plan applications so far this year, covering both urban and rural areas (CQ HealthBeat , 4/5). "CMS is confident that, throughout the country, beneficiaries will have access to prescription drug plans on schedule," McClellan said (Washington Post, 4/6).
- Dual Eligibles: McClellan also said CMS is working to identify dual eligibles to help them find a Medicare Advantage plan that meets their needs and to ensure the transition of drug coverage from Medicaid to Medicare is smooth. Sen. Daniel Akaka (D-Hawaii) has expressed concern that the imposition of copayments for the Medicare drug benefit could harm dual eligibles and that Medicare drug plan formularies might exclude medications that Medicaid beneficiaries use (CQ HealthBeat , 4/5).
- Retiree Coverage: McClellan said he expects more than 90% of employers who provide prescription drug coverage to retirees to continue providing the coverage once the Medicare drug benefit begins (Knight Ridder/St. Paul Pioneer Press, 4/5).
In related news, Senate Democratic leaders said they now have enough support in the Senate to force a vote on legislation that would allow the HHS secretary to negotiate drug prices with pharmaceutical companies, Roll Call reports. A vote on the same issue failed 49-50 during the Senate's debate on the fiscal year 2006 budget.
However, Sens. Arlen Specter (R-Pa.) and Gordon Smith (R-Ore.) now have indicated that they would support a stronger bill by Sens. Olympia Snowe (R-Maine) and Ron Wyden (D-Ore.) authorizing the practice, giving the legislation 51 supporters. According to Roll Call, passage of the bill in the Senate still is "not assured," and the legislation faces "a much tougher road" in the House.
The Bush administration opposes the legislation, saying giving the secretary of HHS authority to negotiate directly with pharmaceutical companies would amount to price controls (Pierce, Roll Call, 4/6).
The federal government is reconsidering its policy of putting beneficiaries' Social Security numbers on Medicare cards "[a]mid growing concerns about identity theft," the Dow Jones/Wall Street Journal reports. Consumers Union last year sent a letter to CMS asking the agency to stop using Social Security numbers on cards and mailings to beneficiaries.
In response to such concerns, CMS is "considering whether there are other ways to identify people," CMS spokesperson Gary Karr said, adding, "There would be a huge systems change that you would have to undertake, and you'd have to figure out what is the cost, and if that cost is worth it." The agency estimates that removing the Social Security numbers from Medicare cards and issuing new cards would cost more than $100 million (Chu, Dow Jones/Wall Street Journal, 4/6).
The following summarizes news coverage of new research related to Medicare.
- AMA Survey: A survey released Tuesday by the American Medical Association found that 38% of physicians say they would limit the number of Medicare beneficiaries they treat if CMS reduced physician payments by 5% in 2006, CQ HealthBeat reports. The survey also found that 61% of doctors would defer purchase of new medical equipment and 54% would delay purchase of information technology if the reduction took place (CQ HealthBeat , 4/5).
- Medical Imaging: A study released Tuesday by the Coalition for Patient Centered Imaging said that the recent growth in medical imaging services in Medicare is "in line with the overall growth rate" for Medicare Part B, CQ HealthBeat reports. The Medicare Payment Advisory Commission in its annual report to Congress said that diagnostic imaging services in Medicare grew more quickly than any other type of physician service between 1999 and 2003 and urged Congress to require HHS to set standards for all providers who perform diagnostic imaging studies. However, researchers from the Lewin Group, which performed the new study, said that the average annual growth in the number of imaging services per 1,000 Medicare beneficiaries between 1999-2001 and 2001-2003 "remained fairly stable at approximately 11%." CPCI said that requiring accreditation and certification for physicians to perform diagnostic imaging would harm access to care (CQ HealthBeat , 4/5).