Medicare Part D plans cover majority of drugs used by dual-eligible consumers
By David Ferguson
The Medicare Part D plan covers the bulk of medications commonly used by both Medicare and Medicaid beneficiaries, according to a new report from the Office of the Inspector General (OIG).
"Overall, we found that the rate of Part D plan formularies' inclusion of the 196 drugs commonly used by dual eligibles is high, with some variation," the report summary said. On average, Part D formularies covered 95 percent of the 196 medications most commonly used by people who qualify for both Medicaid and Medicare.
"In addition," the OIG said, "71 percent of the commonly used drugs are included by all Part D plan formularies. These results are largely unchanged from OIG's findings for formularies reported in the related 2014 mandated annual report."
Part D formularies vary from insurer to insurer as stated under the Medicare Modernization Act of 2003, which was enacted to provide subsidies for seniors who need assistance with prescription drug costs. The program was implemented in 2006, but has remained a contentious topic in Washington's current partisan environment.
The OIG's report is the fifth in a series of transparency reports that are mandated under the Affordable Care Act.
In other OIG news, the agency called for improvements in billing practices related to the implementation of new therapies at Skilled Nursing Facilities. CMS also found that the state of New Jersey has been unable to show that workers in its state hospice facilities meet employee health requirements.
- here's the OIG report (.pdf)
- check out the OIG SNF report
- read the OIG New Jersey report
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