Medicare Drug Benefit Deadline Extended for Some Beneficiaries
CMS officials have announced that the agency will allow some low-income Medicare beneficiaries additional time to enroll in the prescription drug benefit without financial penalty, the Wall Street Journal reports. Under a new policy announced this month, CMS will allow "ongoing" enrollment in the Medicare prescription drug benefit for beneficiaries who qualify for a low-income subsidy.
Medicare beneficiaries who qualify for the subsidy and missed the May 15 deadline would have had to wait until January 2007 to enroll in the prescription drug benefit without the new policy, according to the Wall Street Journal.
CMS estimates that 8.2 million Medicare beneficiaries qualify for the subsidy, which is available to individual beneficiaries with annual incomes of less than about $15,000 and assets of less than $11,500. However, only 4.7 million Medicare beneficiaries had applied for the subsidy as of March 31, and only about 1.6 million of those have qualified (Wall Street Journal, 4/14).
The AP/Philadelphia Inquirer on Friday examined how the NAACP and other advocacy groups have to encourage minority Medicare beneficiaries to enroll in the prescription drug benefit. Although NAACP officials opposed President Bush during his re-election campaign, the group has helped the Bush administration "promote what has become one of the administration's signature programs," the AP/Inquirer reports.
Myisha Patterson, national health coordinator for NAACP, said, "We have to separate the benefit from the politics and the administration and take it for what it is. It's access to prescription drugs for people who didn't have it before."
The National Alliance for Hispanic Health also has helped the Bush administration promote the Medicare prescription drug benefit, NAHH Vice President Adolph Falcon said.
Kathleen Harrington, director of external affairs for CMS, said the agency has asked advocacy groups, churches and civic organizations to help organize Medicare prescription drug benefit enrollment events in minority communities. "In some of these communities, we've faced some culture barriers where there is a lack of trust in government, a natural suspicion, in addition to language barriers," Harrington said, adding, "That's why we've established these partnerships with people who have the trust of the community" (Freking, AP/Philadelphia Inquirer, 4/14).
Senate Finance Committee Chair Chuck Grassley (R-Iowa) and Sen. Max Baucus (D-Mont.), ranking member of the committee, have asked CMS officials about the lack of anti-fraud programs for the Medicare prescription drug benefit, CQ HealthBeat reports. Grassley and Baucus said that Congress has allocated more than $100 million to CMS to establish such a program.
"There's no excuse for anything but an aggressive, organized initiative by the federal government," Grassley said in a statement. He added, "Medicare officials need to get the anti-fraud program off their desks and on the ground."
CMS spokesperson Peter Ashkenaz said that the agency has begun a "multipronged" effort to detect fraud in the Medicare prescription drug benefit, such as the use of the Medicare Rx Integrity Contractor since November 15, 2005. MEDIC has detected a number of fraud cases, such as a scam in which telephone callers attempt to obtain bank account numbers from Medicare beneficiaries and promise prescription drug coverage for $299, he said.
Ashkenaz added that CMS will hire more contractors in future months to detect fraud among Medicare prescription drug plans, contractors and beneficiaries. The contractors will refer fraud cases to state, local and national law enforcement officials, he said (Carey, CQ HealthBeat, 4/13).
Summaries of two editorials and an opinion piece on the Medicare prescription drug benefit appear below.
Burlington Free Press: The telephone hotline established by Vermont to address problems with the launch of the Medicare prescription drug benefit had "an unexpected benefit," according to a Free Press editorial. "Callers to the Medicare hotline sometimes mentioned other concerns they had about state programs," and the hotline "in essence became one-stop shopping for information on a variety of issues," the editorial states. "It's probably not practical or economical to pull so many workers from around the state to one central location too often," but the state Human Services Agency "should consider staffing such an effort once or twice a year and publicizing the hotline," the editorial states (Burlington Free Press, 4/13).
Orlando Sentinel: "It's clear" that many Medicare beneficiaries "bought into the argument that the program was simply a boon to the pharmaceutical industry and was too complicated for average Americans to understand," but "those brave souls who have enrolled like" the program, a Sentinel editorial states. "The complaint that drives the political agenda is that the program is too complex," the editorial states, adding, "Making any choice can be difficult, but having more options is good" (Orlando Sentinel, 4/14).
- Richard Stefanacci, Philadelphia Inquirer: CMS should extend the May 15 enrollment deadline for the Medicare prescription drug benefit by eight weeks, Stefanacci, founding executive director of the Health Policy Institute of the University of the Sciences, writes in an Inquirer opinion piece. Over that time, "let seniors change plans if they're finding their first choice inappropriate," he writes, adding that the "government should get health care providers involved in the selection process" because "the expertise needed to assess the options and make evaluation is often outside" the ability of family members and friends. In addition, providers should have the ability to write "specific prescription medically necessary" on prescriptions to "require drug plans to fill the prescription as written, regardless of their favored product," Stefanacci writes (Stefanacci, Philadelphia Inquirer, 4/14).
Leslie Norwalk, deputy administrator for CMS, is scheduled to discuss the Medicare prescription drug benefit on Friday at 4 p.m. ET in an "Ask the White House" chat. A transcript of the chat will be available online.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.