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Medicare Prescription Drug Program
Coalition Wants Beneficiaries in Special Living
Facilities Exempt from Medicare Drug Copays
Medicare program exempts dual eligibles only in
nursing homes
June 8, 2006 Expressing concern for the health
and safety of patients in certain homes providing care for the elderly,
disabled and mentally challenged, more than three dozen organizations
have joined a collation to get Congress to make changes in the Medicare
prescription drug program to eliminate drug co-payments for dual
eligibles those covered by Medicare and Medicaid. Dual eligibles in
nursing homes are already exempted by the law.
The National Center For Assisted Living (NCAL) and
the American Health Care Association (AHCA) took the lead to organize
the coalition in support of Sen. Gordon Smiths bill, The Home and
Community Services Co-payment Equity Act of 2006 (S. 2409). The groups
signed a letter delivered to Sen. Smiths office Tuesday encouraging
passage of his legislation.
S. 2409 seeks to eliminate Part D co-payments for
dual eligibles that are residing in assisted living, residential care
facilities, and other licensed facilities including group homes for
people with mental retardation and developmental disabilities,
psychiatric health facilities, and mental health rehabilitation centers.
Dual eligible beneficiaries receiving services
under home and community-based waivers in home settings would also be
relieved of Part D co-payments under the bill.
Assisted living providers are concerned about the
quality of life for their dual eligible residents who cannot afford the
co-payments of their medications under the new Medicare Prescription
Drug Plan program, said David Kyllo, NCALs executive director.
Passage of S. 2409 would alleviate the financial pressure they are
experiencing and ensure that these residents receive their medications.
Congress exempted dual eligibles living in nursing
facilities from any cost sharing for Part D prescription drugs. About
121,000 people residing in assisted living and residential care
facilities are dual eligible. Similar to nursing facility residents,
assisted living dual eligibles have limited incomes. Under Part D,
co-payments for dual eligibles are between $1 and $5 dollars per
prescription. According to recent studies, the average assisted living
resident needs between eight to 10 medicationsabout the same as nursing
facility patients.
These co-pays may not seem like a lot of money,
but if you need eight medicines a month the expense adds up quickly for
people with extremely limited means, said Kyllo. For some dual
eligible residents these prescription co-payments will exceed their
monthly personal allowances under Medicaid.
Coalition members represent consumers, health care
and long term care providers, geriatric care professionals, pharmacists,
and state officials.
Below are the organizations that signed the letter
to Sen. Smith:
● Alliance for Holistic Aging
● Alzheimer's Association
● American Academy of Home Care Physicians
● American Association of Homes and Services for the Aging
● American Geriatrics Society
● American Health Care Association
● American Medical Directors Association
● American Network of Community Options and Resources
● American Seniors Housing Association
● American Society of Consultant Pharmacists
● Assisted Living Federation of America
● Benjamin Rose Institute
● Center for Medicare Advocacy
● Consumer Consortium on Assisted Living
● Epilepsy Foundation
● Families USA
● National Adult Family Care Organization
● National Alliance on Mental Illness
● National Association of Boards of Examiners of Long Term Care
Administrators
● National Association for Home Care & Hospice
● National Association of Professional Geriatric Care Managers
● National Association of Social Workers
● National Association of State Directors of Developmental
Disabilities Services
● National Association of State Ombudsman Programs
● National Association of State Units on Aging
● National Center for Assisted Living
● National Community Pharmacists Association
● National Hospice & Palliative Care Organization
● National Multiple Sclerosis Society
● Paralyzed Veterans of America
● The Arc of the United States
● United Cerebral Palsy
● Volunteers of America
● Washington State Long Term Care Ombudsman Program
>> To view the entire letter, please
visit:
www.ahca.org/news/ltr_smith_06060.pdf
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