Medicare Part D changes draw critics


Despite the success of Medicare's prescription drug program, changes proposed by the Obama administration are coming under heavy fire, reports Kaiser Health News.

Patient groups, pharmaceutical manufacturers and lawmakers in both parties are pushing back against changes the administrations says intend to help beneficiaries make good choices and save taxpayers money. Critics maintain there's no need to fix a program that isn't broken.

The proposed changes include limits on the number of plans insurers can offer seniors, new rules on the drugs that insurers must cover and more more pharmacies allowed into a plan's "preferred pharmacy network" as long as they meet the plan's terms and conditions.

The Centers for Medicare & Medicaid Services estimates the proposed changes would save $1.3 billion between 2015 and 2019.

"There is something [in the rule] that touches every single stakeholder in the Part D world," Lisa Joldersma, vice president of public programs policy at Pharmaceutical Research and Manufacturers of America, an industry trade and lobbying group, told Kaiser Health News.

However, in a letter to CMS, more than 200 groups representing patients, seniors, health insurers, drug makers oppose the changes, saying they would "dramatically expand the federal government's role in Medicare Part D despite the fact that there is no compelling reason for doing so."

Similarly, a bipartisan majority of the Senate Finance Committee sent its own letter last week. "Many of the proposed changes are untested and unstudied and could result in significant loss of beneficiary choice, access and consumer protections," the letter states.

The changes have some supporters, though. Joe Baker, president of the Medicare Rights Center, says seniors have difficulty sorting through too many Medicare Part D choices,  Kaiser Health News noted.

Separately, a recent study of supplemental Medigap plans found they boost utilization of Medicare services by encouraging more unnecessary tests and procedures. In particular, it  found Medigap increases Medicare Part B physician claims by 33.7 percent and Part A hospital stays by 23.9 percent.

To learn more:
- read the Kaiser article
- here's the groups' letter (.pdf)
- find the Senate Finance Committee letter

Related Articles:
CMS drafts new Medicare integrity regulations
Medigap 'buffet' drives up Medicare spending
New online tool tracks doc prescribing habits