U.S. administration pulls back on Medicare drug benefit proposals
Source: Reuters
(Reuters) - The Obama administration on Monday told members of Congress that it will not finalize controversial changes to the Medicare Part D prescription drug benefits program "at this time," following weeks of growing opposition to the proposals from a broad coalition of interests.
U.S. Centers for Medicare and Medicaid Services(CMS) Administrator Marilyn Tavenner said in a letter to lawmakers that her agency will instead seek new input from stakeholders before advancing some or all of the changes "in future years."
Read more: http://www.reuters.com/article/2014/03/10/us-usa-healthcare-medicare-idUSBREA2706420140310
So, were the changes something the people genuinely didn't want or is it another case of multi-national corporations waging an ad campaign to misinform voters and get them to fight for higher profits for their companies?
Autumn
(44,762 posts)I thought the changes to Medicare Part D prescription drug benefits were needed.
okaawhatever
(9,453 posts)need to be made, but this change is unpopular among seniors. What most of us don't know is how valid the criticism is. Does it come from a real concern they won't be protected with the new regs or a campaign by big pharma to convince them of such?
JDPriestly
(57,936 posts)WASHINGTON, March 10, 2014 /PRNewswire-USNewswire/ -- A new actuarial study released by The Pharmaceutical Care Management Association (PCMA) examining the impact proposed changes to the Medicare prescription drug program finds that eliminating preferred pharmacy networks in Part D would increase premiums by approximately $63 annually for over 75 percent of Part D enrollees and raise overall program costs by an estimated $24 billion over the next ten years.
"CMS' proposal to eliminate preferred pharmacy networks will make it harder and more expensive for seniors to access prescription drugs," said PCMA President and CEO Mark Merritt.
The study examines the sections of CMS' proposed rule on preferred pharmacy networks. Currently, more than 75 percent of Part D beneficiaries are enrolled in plans that feature preferred pharmacy networks.
Key findings from the study, which was sponsored by PCMA and prepared by Oliver Wyman, include:
- As of February 2014, more than 75% of prescription drug plans (PDP) enrollees are in plans with preferred pharmacy networks and these enrollees could be adversely affected by the elimination of plans utilizing preferred pharmacy networks.
- The preferred pharmacy networks provision would increase premiums for the affected population by an average of approximately $63 per year for the 2015 plan year.
- The rule could increase cost sharing among PDP enrollees by an average of $80 to $100 per year.
- Since the rule would inflate the national average benchmark for Part D plans, CMS would pay an estimated additional $64 in direct subsidies per beneficiary per year in 2015, for a total increased payment of nearly $1.5 billion in 2015 across all PDP enrollees, based on Part D enrollment of approximately 23 million beneficiaries.
- Over a 10-year period, the increased cost of eliminating preferred pharmacy networks is estimated to be approximately $990 per affected enrollee, and the cost would be approximately $24 billion to CMS in the form of higher direct subsidy payments.
http://www.prnewswire.com/news-releases/new-study-proposed-medicare-part-d-rule-would-increase-medicare-costs-24-billion-hike-senior-premiums-249302061.html
I can only say that the cost of hospital co-payments and other things in my Medicare plan have risen for me this year. Seems to coincide with the ACA coming fully on board. I don't know whether that is merely a coincidence. I have to spend a lot of money on over the counter medications in addition to the other costs. Social Security does not rise when they reduce Medicare benefits. It's kind of a way of circumventing the outcry the government faces when it announces that it is reducing Social Security benefits. As you age, the little demons in your DNA and the slightest careless habit with regard to your health over the course of your life seem to emerge and take over. Each little thing from high blood pressure to diabetes to poor vision or a hearing vulnerability or having worn high-heeled shoes to work all those years, having lifted heavy stuff, having worked long hours, it all comes back to you and you feel it in your body.
Old age is the profit center of the pharmaceuticals.
jtuck004
(15,882 posts)premium prices down, and still hoover as much money for the insurance company out of your pocket as they can.
You can read some of the conversations by ins cos and others out there, they talked about out of pocket being higher to get the premiums more attractive. Easier sell, harder on the pocketbook, more $$$ for the corps. And people went for it
tosh
(4,422 posts)"Preferred Pharmacy" Drug Plans More Expensive for Medicare and Taxpayers, Comparison Finds
http://www.ncpanet.org/index.php/news-releases/1902-qpreferred-pharmacyq-drug-plans-more-expensive-for-medicare-and-taxpayers-comparison-finds-
Alexandria, Va. Mar. 7, 2014 - As the public comment period for Medicare's proposed rule for Medicare Part D drug plans draws to a close, cost comparisons using the program's Plan Finder website suggest that "preferred pharmacy" drug plans often are more expensive than "open" networks, in potential violation of the Social Security Act, the National Community Pharmacists Association (NCPA) said today.
"Anyone who is concerned about Medicare beneficiaries, protecting taxpayer dollars, or the long-term solvency of Medicare should be troubled by the impact of 'preferred pharmacy' drug plans," said NCPA CEO B. Douglas Hoey, RPh, MBA. "The plans have been aggressively, and, in some cases, deceptively marketed to seniors, forcing some to travel 20 miles or more to reach a 'preferred' pharmacy. In many instances they appear to be increasing Medicare costs as well."
Using the Medicare Plan Finder website that was established to help seniors evaluate and choose a drug plan, NCPA staff compared "preferred pharmacy" plans to open network plans that do not financially penalize patients for using the pharmacy of their choice. The analysis compared six plans with both preferred and open network options, using a "market basket" of the same six drugs: alendronate sodium 70 mg; hydrochlorothiazide 25 mg; lisinopril 20 mg; metformin hcl 500 mg; metoprolol tartrate 50 mg; and simvastatin 40 mg. (Previous NCPA Plan Finder comparisons focused just on preferred pharmacy plans and contrasted the costs at the preferred pharmacy vs. the costs of choosing a non-preferred pharmacy.)
According to the analysis (factoring in deductibles and premiums):
In 9 out of 13 instances, Medicare paid more for preferred network insurance plans than for open network insurance plans.
In 11 out of 13 cases, the consumer paid more for open network insurance plans than for preferred network insurance plans.
In 6 out of 13 instances, the preferred network insurance plan has a higher total cost.
In sum, lower copays to attract beneficiaries to preferred network plans are paid for by shifting costs to Medicare and taxpayers. By law, Medicare costs associated with a preferred network plan must not exceed cost associated with a comparable open network plan.
To address this situation, Medicare has proposed two common sense solutions. First, prohibit "preferred" arrangements between drug plans and pharmacies from increasing costs to Medicare by requiring greater transparency. Second, allow "any willing pharmacy" to participate in a preferred network if it accepts the requisite terms.
"Community pharmacists support these aspects of Medicare's proposed rule and encourage the agency to implement them as soon as possible," Hoey added.
Dozens of members of Congress have spoken out in favor of this policy. In addition, Medicare beneficiary advocates such as the Alliance for Retired Americans; American Federation of State, County and Municipal Employees (AFSCME); California Health Advocates; Center for Medicare Advocacy, Inc.; Families USA; Medicare Rights Center; National Committee to Preserve Social Security and Medicare; National Council on Aging; and National Senior Citizens Law Center have expressed support for this particular provision of the Medicare proposed rule.
To learn more, go to www.ncpanet.org/medicare.
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The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent an $88.7 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists.
jwirr
(39,215 posts)L0oniX
(31,493 posts)SoapBox
(18,791 posts)Certainly not a surprise...and through the whole thing, we The People (excluding Corporate Personhood) get screwed.
okaawhatever
(9,453 posts)blkmusclmachine
(16,149 posts)Sunlei
(22,651 posts)That's will drive independent pharmacies out of business, some of those independent local pharmacies have much lower prices.
Healthcare of all kinds is horrible for the consumer, when the Drug and now the Growing-insurance corps are both "for profit".