GOP Weighs Idea to Drop Medicare Penalty

[brooklynite]

WASHINGTON - Under election-year pressure, congressional Republicans are considering elimination of the financial penalty for seniors who miss a May 15 enrollment deadline under the new Medicare prescription drug program.

The deadline itself would remain in effect, officials familiar with the discussions said Friday, meaning that most eligible seniors who do not sign up by May 15 would have to wait until Nov. 15 before they could do so.

However, a penalty equal to 1 percent of premium costs per month would be waived once enrollment reopened.

The drug program is voluntary, and individuals who never enroll would not incur a penalty.

http://news.yahoo.com/s/ap/20060428/ap_on_go_co/medicare_drugs_1

[Roon]

1. I wish I never enrolled

I went from having no copay to having a 55.00 copay. :-(

[jwirr]

4. Ditto. 10 copay to $100.00 and no money to pay it with.

[daveskilt]

2. it is just a money grab for pharmacy companies- here is how

The second that this program was announced the major pharmacies set up Fiscal intermediaries (many times through other bush donor financial services companies). The FI then determines the plan that the seniors are enrolled in (automatically and without their consent if they are currently in a care facility). The plan through the FI is contracted to the pharmacy that owns it through a third party bank. The pharmacy then sets a drug price which the FI will accept and (using your medicare funds and copay) pay a portion of. The rest of the "cost" that is arbitrarily set by the pharmacy is offset by a contractual write off under medicare allowable expense and the pharmacy gets back the difference from medicare. This lets the pharmacy charge whatever it likes and get paid from medicare 2 different ways.

The biggest crock in the whole thing is the "donut hole" coverage where anyone who requires hospitalization or IV's is going to end up with a massive bill until the threshhold is met - they spin this as a max spend limit of a few thousand BUT after the threshhold for coverage is passed the patient is responsible for 5% of the artificial cost the pharmacy set and then through its shell FI comapny agreed to pay its self.

take 1 patient with a common hospital infection like MRSA or VRE - they get put on IV Zybox 3 times a day for 3 weeks at $600 per dose - 5% is $1890. patients in nursing homes on routine meds could have a bill of 4-5 hundred a month easily where before medicaid or medicare part B would pick up the cost.

[Tempest]

3. They wouldn't consider dropping this

If it wasn't an election year.