Vote Sought on Bill To Extend Drug Benefit Enrollment
Forty-eight senators on Wednesday sent a letter to Senate Majority Leader Bill Frist (R-Tenn.) asking him to address legislation that would extend the current May 15 deadline for enrollment in the Medicare prescription drug benefit, the Boston Globe reports. The letter, which was written by Sens. Bill Nelson (D-Fla.) and Olympia Snowe (R-Maine), urges Frist to bring to a vote one of the recently introduced bills to extend the deadline (Krasner, Boston Globe, 4/20).
Nelson has introduced a bill (S 1841) that would extend the enrollment deadline and is co-sponsoring similar legislation (S 2168) with Snowe.
Last month, the Senate voted 49-49 to reject a budget resolution amendment introduced by Nelson that would have extended the deadline to December 31 (Schuler, CQ Today, 4/19).
In the letter, Nelson and Snowe said, "By extending the enrollment deadline and delaying late enrollment penalties, we can make sure that our constituents are not forced to make hasty decisions about their health care" (St. Petersburg Times, 4/20). The letter adds, "Sorting through these plans has proven to be difficult and time consuming ... the Medicare drug program is experiencing a variety of implementation problems that have disproportionately affected the most vulnerable beneficiaries."
Sen. Debbie Stabenow (D-Mich.), who signed the letter, said, "From every angle, [the drug benefit] has been a disaster, and it needs to get fixed," adding, "In the short-run, we need at least to give folks more time to be able to figure this out" (Kleffman, Contra Costa Times, 4/20).
Sen. Edward Kennedy (D-Mass.) said in a statement, "Our seniors deserve to be given every opportunity in choosing a drug plan that best fits their needs and not held to unrealistic deadlines. It's clear that America's seniors have experienced immense difficulty with the administration's prescription drug program ..." (Boston Globe, 4/20).
Meanwhile, Rep. Pete Stark (D-Calif.) said that 187 House members have signed a discharge petition on his own deadline extension bill (HR 3861), which has more than 160 co-sponsors (CQ Today, 4/19). However, he said the administration should act to extend the deadline without legislation because if an extension bill reaches a vote in the House, lawmakers might decide to repeal the entire program (Contra Costa Times, 4/20).
CMS has said it will allow some low-income beneficiaries to enroll in the drug benefit after the deadline without financial penalty (Boston Globe, 4/20). However, Bush administration officials last week said that CMS lacks the legal authority to extend the deadline for all beneficiaries (St. Petersburg Times, 4/20).
CMS spokesperson Peter Ashkenaz on Wednesday said, "The administration doesn't support an extension," adding, "Enrollment is surpassing our goals, satisfaction is high, and we see no reason to extend a deadline that's working. We don't' want Medicare beneficiaries to put off savings" (Boston Globe, 4/20).
In related news, insurers sponsoring Medicare drug plans have mailed "tens of thousands" of letters to beneficiaries saying they will be disenrolled from the drug benefit because they have not paid their premiums, USA Today reports. The letters say that if missed payments are not made by May 31, "we will have to disenroll you."
However, "many who received the letters in the past few days insist they have already paid," USA Today reports. Some beneficiaries said they have signed up for automatic deductions from their Social Security checks to pay for premiums, while others who received the letters qualify for a low-income subsidy that covers the cost of premiums, according to officials with beneficiary counseling programs in Arkansas, California, New York and Pennsylvania.
Jackie Kosecoff -- an executive at UnitedHealth, which has 4.5 million beneficiaries enrolled in Medicare drug plans -- said the insurer mailed letters to beneficiaries who are one to four months behind in payments.
UnitedHealth spokesperson Dominick Washington said the letters inform beneficiaries of payment options and assure them they will not be disenrolled because of late payments.
CMS officials said a one- to two-month delay in processing enrollment in Social Security's automatic deduction program might be partly to blame for the problems.
CMS Administrator Mark McClellan added that officials are "seeing only a low rate" of questions related to such billing issues (Appleby, USA Today, 4/20).
Meanwhile, organizations representing the insurance industry, chain drug stores and community pharmacists have agreed on uniform language for informing pharmacists of coverage policies for different drug plans, CQ HealthBeat reports. The standardized language will indicate to pharmacists whether a particular drug is covered, whether prior authorization is required for a drug, whether coverage limits have been exceeded and whether a pharmacy is part of a plan's network.
Pharmacists and insurance industry representatives said the agreement will help reduce wait times and confusion among beneficiaries filling prescriptions.
Bruce Roberts, executive vice president and CEO of the National Community Pharmacists Association, said the agreement "will make a tremendous difference to pharmacists delivering drugs in a timely fashion."
McClellan also said the agreement would reduce the "time and effort of pharmacists" filling prescriptions. "We expect the entire industry to implement these practices as soon as possible," he said (Carey, CQ HealthBeat, 4/19).
The Medicare Payment Advisory Commission on Wednesday considered data from a MedPAC survey of Medicare beneficiaries' experiences with the drug benefit. According to CQ HealthBeat, MedPAC is in the process of "wading into Part D issues by reviewing the quality of information" that beneficiaries have available when making decisions about the program.
According to MedPAC staffer Joan Sokolovsky, the data show that half of beneficiaries surveyed spent at least eight hours making a decision about the drug benefit. About two-thirds of beneficiaries said they made a decision by themselves, while a few said they sought help only from doctors, pharmacists or counselors. Only 11% used the Medicare Web site, while 22% called the Medicare phone line for help on selecting a plan, the survey shows.
MedPAC Commissioner David Smith, who participated in MedPAC-sponsored focus groups with beneficiaries, said there was a "lot of anger" among beneficiaries who thought the enrollment process was "too confusing" and "too hard." However, he added that once beneficiaries successfully filled a prescription, they expressed "a surprising amount of satisfaction" (Reichard, CQ HealthBeat, 4/19).
APM's "Marketplace" on Wednesday reported on the advisory opinion that pharmaceutical companies' patient-assistance programs for low-income Medicare beneficiaries are lawful under the prescription drug benefit.
The segment includes comments from Robert Hayes, president of the Medicare Rights Center; Ian Spatz, vice president for public policy at Merck; former Rep. Billy Tauzin (R-La.), president of the Pharmaceutical Research and Manufacturers of America; and a low-income Medicare beneficiary who participated in a patient-assistance program (Palmer, "Marketplace," APM, 4/19).
The complete segment is available online in RealPlayer.