Some Senators Back Off Plans for Medicare Reimbursement Bill
Some senators appear to be retreating from plans to push for legislation (S 2181) that would require the federal government to reimburse states that are covering the cost of prescription drugs for Medicare beneficiaries who have been unable to obtain medications under the new drug benefit, CongressDaily reports (Heil, CongressDaily, 1/25). However, other senators continue to say legislative action might be necessary to address problems with the drug benefit.
The comments came after HHS Secretary Mike Leavitt and CMS Administrator Mark McClellan conducted a private meeting with members of the Senate Finance Committee on Wednesday to brief the lawmakers on issues related to the drug benefit (Fagan, Washington Times, 1/26).
On Tuesday, Leavitt and McClellan announced that the federal government would reimburse states that have incurred costs from ensuring access to medications for beneficiaries. At least 26 states are covering the cost of medications for beneficiaries dually eligible for Medicare and Medicaid who have been unable to obtain medications under the drug benefit, according to a survey released Jan. 18 by the National Association of State Medicaid Directors (California Healthline, 1/25).
The Senate bill would require the federal government to directly reimburse states, rather than requiring Medicare drug plans to reimburse the states, CongressDaily reports.
After Wednesday's meeting, Sen. Olympia Snowe (R-Maine), a bill co-sponsor with Sen. Frank Lautenberg (D-N.J.), said the legislation might "not be necessary" (CongressDaily, 1/25). She added, "It seems to me that the secretary is really working to make sure this reimbursement occurs."
Sen. Charles Schumer (D-N.Y.) said he is not ready to abandon support for the legislation, adding that the "devil is in the details."
Finance Committee Chair Chuck Grassley (R-Iowa) said, "So far, HHS officials don't need any legislation to help with the drug benefit, but if that changes, my committee will respond." Grassley said he plans to hold a committee hearing in February to hear a progress report on the drug benefit (Reichard, CQ HealthBeat, 1/25).
Sen. Ron Wyden (D-Ore.) said, "I think there's no question that the issue of prescription drugs will be back on the (Senate) floor in some form this year" (Washington Times, 1/26).
Sen. Max Baucus (D-Mont.), ranking member of the committee, said Leavitt and McClellan agreed to establish a timeline for correcting problems with the drug benefit (CQ HealthBeat, 1/25). He added, "The good news is the administration does admit there's problems."
Baucus said he and Grassley would work to "nail down" the timeline, but added that if he is unsatisfied with the plan, "then I think legislation will be much more likely" (Washington Times, 1/26). Baucus said he expects to receive details on the timeline within two days.
A CMS spokesperson said, "We'll provide a timeline as quickly as possible."
Schumer also said that Leavitt indicated the Feb. 15 deadline for states to file for reimbursement under the administration's plan would be extended for New York and some other states that might not be able to meet it. Schumer said the deadline was "unrealistic -- and [Leavitt] backed off" Feb. 15 as a deadline.
Snowe said she will continue to push for a bill (S 2168) that would extend from May 15 to Dec. 31 the deadline for beneficiaries to enroll in the drug benefit without paying a penalty (CQ HealthBeat, 1/25). According to AP/Long Island Newsday, at least 140 lawmakers -- most of whom are Democrats -- support various bills that would extend the enrollment deadline.
Snowe said, "Given all the problems, people might get a plan that doesn't meet their expectations. Recognizing that, we should be flexible."
Sen. John Kyl (R-Ariz.), who is co-sponsoring the bill, said, "I do think we're going to have to look at extending the deadline and recalibrating the penalties because I don't want a situation where, because of this confusion, people decline to sign up, then face a large penalty."
Grassley said an extension could lead to higher premiums for drug plans, adding, "Rather than delay help for seniors, we need to fix the problems."
Leavitt spokesperson Christina Pearson said the secretary would not support an extended enrollment deadline. "There is a lot of time for seniors to consider their options and sign up for a plan," Pearson said.
In the House, 10 bipartisan co-sponsors support a bill that would extend the enrollment deadline to June 30, 2007. A second House bill, which has 131 co-sponsors, would extend the deadline to Dec. 31 and allow beneficiaries to change plans once during the year. Most supporters of the second bill are Democrats, according to AP/Newsday.
Rep. Walter Jones (R-N.C.), who supports both bills, said the drug benefit could be an issue in the November congressional elections, but "[h]opefully, it won't be because we'll do what's right and that is to extend the deadline" (Freking, AP/Long Island Newsday, 1/25).
Wyden said Congress should take action to limit the number of available Medicare drug plans and standardize them to help beneficiaries to make comparisons (CQ HealthBeat, 1/25).
In addition, House Minority Leader Nancy Pelosi (D-Calif.) asked House Speaker Dennis Hastert (R-Ill.) to investigate the role of lobbying firm Alexander Strategy Group in the passage of the 2003 Medicare law. Pelosi said the firm has ties to Rep. Tom DeLay (R-Texas) and lobbyist Jack Abramoff (Krasner, Boston Globe, 1/26).
The following summarizes other coverage of issues related to the drug benefit.
CongressDaily: CongressDaily on Thursday examined how "some supporters and foes" of the Bush administration say the Republican party "can learn lessons about the free-market approach" to health care policy from problems with the drug benefit (Heil, CongressDaily, 1/26).
- San Francisco Chronicle: The Chronicle on Thursday examined the difficulties beneficiaries, pharmacists and health care providers are encountering with the drug benefit and profiled "a few examples of the malfunctioning of Medicare" since the coverage began Jan. 1 (Colliver, San Francisco Chronicle, 1/26).
CBS' "Evening News" on Wednesday reported on Medicare beneficiaries' difficulty accessing prescription drugs because of the prior authorization requirement by the new prescription drug benefit. The segment includes comments from Vicki Gottlich, an attorney with the Center for Medicare Advocacy, Medicare beneficiaries and their families (Andrews, "Evening News," CBS, 1/25).
The complete segment is available online in RealPlayer.