Latest California Healthline Stories
Groups in California Take Aim at Medicare Payments
How much should Medicare pay doctors and hospitals? That’s the question at the heart of two claims filed in California. One argues that Medicare is shortchanging care providers, while the other maintains that inflated reimbursements are hitting beneficiaries in the wallet.
Pay for Performance a Factor in Medicare Reform
California HMOs have adopted pay-for-performance programs at a higher rate than the national average, and other states are encouraging CMS to adopt the programs, which some see as a way of addressing the sustainability of Medicare and Medicaid.
More Choices for California Medicare Beneficiaries in 2007
CMS officials are praising California beneficiaries’ wider variety of options for Medicare drug coverage in 2007, but some health care advocates say the increased options could lead to more confusion.
Legislation on Drug Benefit Assistance Stalls
Advocates had supported a bill that would have provided subsidies for drug benefit copayments, and some groups say they will seek similar legislation in 2007.
Medicare Beneficiaries Dealing With ‘Doughnut Hole’
A gap in coverage in Medicare prescription drug plans is emerging as an issue for beneficiaries with high prescription drug costs, particularly those who did not retain employer-sponsored drug coverage.
Drug Benefit Enrollment Strategies Expand
Health care advocates are working with community groups and “mining” enrollment information for programs whose membership might include Medicare beneficiaries eligible for subsidies to help offset the cost of prescription drug coverage.
Drug Benefit Enrollment Varies by County
CMS attributes variations in enrollment in the Medicare drug benefit among counties to differences in managed care penetration and populations of dual eligibles, but some health care advocates fault CMS for inadequate outreach efforts.
Medicare Beneficiaries Face Enrollment Deadline
Counselors in California expect an increase in calls for assistance before the May 15 deadline for Medicare beneficiaries to enroll in the prescription drug benefit, as the federal government launches efforts to enroll beneficiaries who have put off choosing a drug plan.
Medicare Drug Benefit Could Increase Use of Generic Drugs
The so-called “doughnut hole” in coverage under the Medicare drug benefit could encourage more consumers to switch to generic drugs, a move that some drugmakers are taking steps to avoid.
Medicare Drug Coverage Has Growing Pains in California
California is one of at least 26 states providing emergency coverage of prescription drug costs for dual eligibles who have been unable to obtain medications under the drug benefit, and some health advocates say that some dual eligibles in California also are facing problems with language barriers and drug plan formularies.