Medicare Might Limit Prescription Drug Plans
CMS is considering limiting the number of plans that insurers can offer under the Medicare prescription drug benefit next year, the agency said in a memo to drug plan sponsors, the Wall Street Journal reports. The memo, dated Feb. 21, says CMS might limit insurers with Medicare drug plans to offering one "basic" benefit plan and one "enhanced" benefit plan in each region.
For this year's coverage, insurers were allowed to sponsor up to three plans per region. The letter also outlines preliminary information about changes to the Medicare drug benefit for next year, including a requirement that plans with 24-hour pharmacies in their network also offer 24-hour phone lines for pharmacists.
In addition, the letter says, CMS is considering altering effective dates of enrollment, so that beneficiaries who sign up near the end of the month would not expect to begin coverage on the first day of the following month. The letter asks insurers to respond by March 1.
CMS spokesperson Gary Karr said, "Last year, we limited the number of choices ... because we didn't think it was reasonable for beneficiaries to have to walk through more." He added, "There are people who think there ought to be even fewer than that; that's one of the reasons to ask this." Karr said, "It would be silly to suggest that we would not incorporate some learning from this year's experience."
A spokesperson for Humana said the insurer agrees "with the thrust of the memo" but needs to review some of the details. Aetna said it needed to review the letter, while Cigna said it planned to respond by March 1 (Lueck, Wall Street Journal, 2/25-2/26).
NPR's "Morning Edition" on Monday reported on the Medicare prescription drug benefit's progress by revisiting people who had been interviewed at the launch of the benefit.
The segment includes comments from President Bush; Jeanne Finberg, directing attorney at the National Senior Citizens Law Center; HHS Secretary Mike Leavitt; Rep. Jim Moran (D-Va.); Sue Wolf Nelson, director of the Family Health Care Pharmacy, part of a community health center in Fargo, N.D., serving low-income and uninsured residents; Jude Walsh, Maine's pharmacy director; and Medicare beneficiaries (Rovner, "Morning Edition," NPR, 2/27).
The complete segment is available online in RealPlayer.