Medicare Drug Benefit Enrollment Deadline Could Be Extended

The Senate on Wednesday voted 76-22 to approve an amendment to the fiscal year 2007 budget resolution that would authorize HHS Secretary Mike Leavitt to extend the May 15 deadline for enrolling in the Medicare prescription drug benefit, CQ Today reports.

The amendment, which was offered by Senate Finance Committee Chair Chuck Grassley (R-Iowa), would give Leavitt the authority to extend the deadline but would not require him to do so. The Grassley amendment also would allow beneficiaries to switch plans once during 2006 without penalty.

The Senate on Wednesday also voted 49-49 to reject an amendment by Sen. Bill Nelson (D-Fla.) that would have mandated an extension of the deadline to Dec. 31 and allowed beneficiaries to change plans once without penalty during 2006 (Angle, CQ Today, 3/15).

Grassley said, "Personally, I think that it's premature to change the date. So I offer this amendment as a compromise" (Riechmann, AP/San Francisco Chronicle, 3/15).

Sen. Kay Bailey Hutchison (R-Texas) -- whose switch to a "no" vote led to the tie on the Nelson amendment -- said, "I really am concerned about this deadline, but I think the Grassley amendment covered it."

Five Republicans -- Sens. Olympia Snowe (R-Maine), Lincoln Chaffe (R-R.I.), Mike DeWine (R-Ohio) and Arlen Specter (R-Penn.) -- voted for the Nelson amendment (CQ Today, 3/15).

In a speech a few hours before the Senate vote, President Bush said he does not support extension of the deadline (Bloomberg/Boston Globe, 3/16).

Speaking at an event in Silver Spring, Md., to promote the drug benefit, Bush said, "There's got to be a fixed time for people to sign up." He added, "We want people to realize there is -- now is the time. ... Rolling back deadlines is not going to help" (Havemann/Wallsten, Los Angeles Times, 3/16).

He said the drug benefit "can be confusing to people, but if you work through the options ... in the end it is a really good deal" (AP/San Francisco Chronicle, 3/15).

In other Senate action related to Medicare, the chamber voted 54-44 in a roll call vote to approve a budget amendment, sponsored by Snowe and Sen. Ron Wyden (D-Ore.), that would authorize the HHS Secretary to negotiate prescription drug prices, the Los Angeles Times reports (Los Angeles Times, 3/16). The amendment would require any savings negotiated by the government to go toward improving the drug benefit or reducing the federal budget deficit (CQ Today, 3/15).

Wyden's office said inclusion of the amendment in the budget resolution would make it easier to pass legislation in the future to require Medicare to negotiate drug prices. Fifty-one votes are necessary to approve such legislation if the amendment is included in the final version of the budget resolution, and 60 votes are needed if it does not make it into the final version, the Times reports (Los Angeles Times, 3/16).

The amendment provides guidance for future legislation rather than carrying the force of law, and first must "survive a conference with the House, which has opposed such proposals," CQ Today reports (CQ Today, 3/15).

In related news, the 90-day period under which Medicare drug plans are required to provide beneficiaries with medications they were taking prior to the drug benefit will end on April 1, and the deadline is prompting concerns from physicians, pharmacists and state officials that beneficiaries will "face more coverage disruptions," USA Today reports. After the transition period ends, drug plans are no longer required to provide coverage for drugs that are not on their formularies.

In addition, "most of the ... states that stepped in on an emergency basis to help low-income beneficiaries also will stop paying" on April 1, USA Today reports. Some beneficiaries "could have to change drugs, file appeals or pay out of pocket" once the transition period ends, according to USA Today.

CMS spokesperson Peter Ashkenaz said drug plans need to educate beneficiaries about the upcoming change. "We have a short time to be working with the plans to make sure the beneficiaries get the information," Ashkenaz said, adding, "Some plans are already doing it."

However, "dozens of state health insurance counselors" said in a conference call on Wednesday that they are unaware of any efforts by drug plans to education beneficiaries about the upcoming change (Wolf/Benedetto, USA Today, 3/16).

In other Medicare news, the American Society of Clinical Oncology on Wednesday outlined its legislative agenda, which includes the passage of legislation that would increase reimbursements for certain cancer drugs, CQ HealthBeat reports.

Deborah Kamin, senior director for cancer policy at ASCO, said the group is seeking introduction of legislation that would make a "technical correction" to the reimbursement system outlined by the 2003 Medicare law. Under the law, Medicare pays physicians 106% of the average sale price of chemotherapy drugs.

ASCO is seeking legislation that would authorize CMS to make an exception in cases in which a physician cannot purchase drugs at a price equivalent to 106% of the ASP. The ASP reflects prices that are available to large buyers, but physician offices often have to pay more for the drugs, ASCO said.

"For almost all drugs, at least some physician practices -- in some cases a significant number of practices -- cannot purchase the drug for the Medicare payment amount," according to a ASCO position paper released Wednesday.

The group has not yet found a sponsor for the legislation, CQ HealthBeat reports.

ASCO also plans to lobby for the continuation of a "pay-for-performance" system for oncologists that was implemented in a demonstration project this year. The system reimburses oncologists at a higher rate if they deliver care based on certain clinical practice guidelines (Reichard, CQ HealthBeat, 3/15).

KCRW's "To The Point" on Thursday is scheduled to include a discussion on the cost of prescription drugs, the reimportation of lower-cost prescription drugs from Canada and the Medicare prescription drug benefit (Olney, "To The Point," KCRW, 3/16). The complete segment will be available online in RealPlayer.