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Medicare Drug Program News
New Effort Planned to Enroll Low-Income Elderly in
Medicare Drug Program
June 12, 2006 – The Social Security Administration
will spearhead a new effort to enroll low-income senior citizens –
already exempted from the late enrollment penalty - in the Medicare drug
program. The focus will be on those age 79 and over. And, on Wednesday,
the House Ways and Means Committee will begin taking a close look at the
first year implementation of the drug program, including why several
million did not enroll.
 SSA Launches Push To Enroll More Low-Income,
Hard-to-Reach Beneficiaries in Medicare Rx Benefit
The Bush administration is undertaking a new effort
to locate and enroll many of the estimated four million Medicare
beneficiaries who have not yet signed up for the Medicare prescription
drug benefit,
USA Today reports.
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Related Stories |
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As Many as Five Million Not in Medicare Drug
Program; 38.7 Million are In
HHS holds news conference following release of new
fact sheet
June 9, 2006 – At a news conference late yesterday
by officials from Health and Human Services, the enrollment figures for
the Medicare drug program were modified slightly from a fact sheet
released earlier in the day. There are 38.7 in the program and four
million to five million beneficiaries are still without drug coverage.
KaiserNet.org reports today on reaction. (Read more about fact sheet in
sidebar story.)
Read more...
Medicare says Drug Benefit Enrollment Up, Costs Down
Average premium drops
to $23, 38 million enrolled
June 8, 2006 – Medicare released a fact sheet today
on the latest results of the Medicare Part D drug program that says 38
million beneficiaries are covered, the average premium is down to $23
and adjustments are being made that will allow low income beneficiaries
to continue to have zero premium drug plan options next year. CMS
officials earlier said there are about 4.5 million beneficiaries note
enrolled and about three million of those beneficiaries are low-income
beneficiaries eligible for assistance.
Read
more...
Read more
on
Medicare Drug Program |
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Beneficiaries with annual incomes below about
$15,000 and assets below $11,500, not including homes, qualify for
government-subsidized premiums and copayments under the drug benefit.
About 38.7 million of the 42.5 million Medicare
beneficiaries have some form of prescription drug coverage, but the
majority of those without coverage -- about three million beneficiaries
-- are eligible for the low-income subsidy, according to the Bush
administration.
As part of the new enrollment effort, the
Social Security Administration will mail 500,000 applications to
several different groups of seniors ages 79 and older, including
low-income seniors, beneficiaries with disabilities, those in low-income
neighborhoods, Hispanics and those who do not handle their own financial
affairs.
The enrollment deadline for most beneficiaries was
May 15, but the government is allowing low-income beneficiaries to sign
up for the drug benefit at any time. The new enrollment drive is "the
latest in a series of attempts by the government and private groups to
lure those seniors who stand to benefit the most" from the program, "but
who are most likely to have missed out on the coverage," USA Today
reports.
Comments
SSA spokesperson Mark Lassiter said, "We're hoping that now that people
are much more aware of this program, that perhaps they will pay more
attention than they did a year ago." James Firman, president of the
National Council on Aging and chair of the Access to Benefits
Coalition, said low-income beneficiaries are "the group that needs the
coverage the most." He added, "The promise and the potential of the
(Medicare law) won't be fulfilled until these people have coverage"
(Wolf, USA Today, 6/12).
Copayments
A coalition of 30 health care groups, including the
National Center for Assisted Living and the
American Health Care Association, have sent a letter to Sen. Gordon
Smith (R-Ore.) expressing support for a bill (S
2409) that would eliminate copays under the drug benefit for dual
eligibles who reside in certain assisted-living facilities,
CQ HealthBeat reports.
Under the bill, which was sponsored by Gordon,
prescription drug copays would be eliminated for dual eligibles who live
in assisted living facilities, resident care program facilities or other
similarly licensed programs. Nursing home residents already are exempted
from copays.
According to the letter, there are 121,000 dual
eligibles in assisted living and residential care facilities who "have
very limited financial resources, often just a few dollars a month from
a personal needs allowance." The letter adds, "For many of these
residents, the amount of their Part D copayments exceeds their monthly
personal needs allowances" (Hopkins, CQ HealthBeat, 6/9).
Hearing
The
House Ways and Means Committee on Wednesday will hold a hearing on
the implementation of the Medicare drug benefit, CongressDaily reports.
Committee Chair Bill Thomas (R-Calif.) plans to use
the hearing to look at "who signed up for the program, who did not and
why," according to CongressDaily. House Majority Leader John Boehner
(R-Ohio) has said he will wait until after the committee reviews
enrollment numbers to decide whether the chamber should take up
legislation that would eliminate the late-enrollment penalty for
beneficiaries who missed the May 15 deadline (CongressDaily, 6/12).
Additional Coverage
The
New York Times on Sunday examined the effects of the Medicare drug
benefit on beneficiaries, pharmacists and doctors in McAllen, Texas, a
town near the Mexican border in the Rio Grande Valley. According to the
Times, beneficiaries in the town are "hav[ing] difficulty getting the
drugs they need," and pharmacists and doctors "are struggling to figure
out which drugs are covered by which plans." In addition, pharmacists
are "swamped with questions and complaints from beneficiaries" and "have
run into many practical problems as they try to navigate a complex
program administered by dozens of prescription drug plans, each with its
own policies and procedures," the Times reports (Pear, New York Times,
6/11).
Letter to the Editor
"Buying drug coverage ... is not like buying a television," Diane
Archer, founder of the
Medicare Rights Center, writes in a letter to the editor of the
New York Times in response to a recent
editorial on the drug benefit. "With drug coverage, you cannot
predict your future needs," Archer writes, adding, "Worse still, the
Part D private drug plans are allowed to change the drugs they cover and
the prices they charge at any time, rendering informed consumer choice
meaningless." She concludes that beneficiaries "deserve a drug benefit
that meets their needs now and in the future, and at a predicable cost
directly through traditional Medicare" (Archer, New York Times, 6/11).
Broadcast Coverage
NPR's "All
Things Considered" on Saturday reported on pharmacists' claims that
payments from pharmacy benefit managers under the Medicare prescription
drug benefit are too slow and too small for community pharmacies to
cover their expenses. The segment includes comments from Mike James,
owner of Person Street Pharmacy in Raleigh, N.C.; Mark Merritt,
president of the
Pharmaceutical Care Management Association; and Edward Scaff, a
former pharmacy owner in Evergreen, Colo. who now operates a liquor
store because it was no longer profitable to sell medications (Rovner,
"All Things Considered," NPR, 6/10). The complete segment is available
online in RealPlayer.
"Reprinted with
permission from kaisernetwork.org You can view the entire
Kaiser Daily Health Policy Report, search the archives, and sign up
for email delivery at
www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser
Daily Health Policy Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. © 2006 Advisory Board Company and Kaiser Family Foundation.
All rights reserved.”
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