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News
Flash:
Bush
Medicare Prescription Drug
Plan Falls short
of Seniors Needs
WASHINGTON
- March 05, 2003 - President Bush released details Tuesday of his
plan to "modernize and improve" Medicare with a for
low-income seniors who agree to abandon traditional Medicare
benefits and sign with a managed care plan.
The
proposal is sure to meet some resistance from pharmacy groups. As
pharmacy leaders feared, it would encourage Medicare enrollees to
obtain prescription coverage through a PBM program, which would
have power to dictate network terms and reimbursement levels to
participating pharmacies. The plan also calls for the use of a
federally subsidized prescription discount card—also
administered by PBMs—for enrollees who opt to remain in the
traditional Medicare fee-for-service program.
"Those
seniors who are happy with their current coverage in traditional
Medicare will be able to keep that coverage and receive help with
the high costs of prescription drugs," the White House
asserted Tuesday. "But seniors who want more choices and
better benefits—including a prescription drug benefit, full
coverage of preventive care and limits on high out-of-pocket
costs—will be able to select options providing these additional
benefits."
Nevertheless,
NACDS president and chief executive officer Craig Fuller expressed
guarded optimism and called the latest proposal
"constructive" for its nod to local pharmacy providers.
"There
are several elements of this plan that we can support,"
Fuller said Tuesday. "Any Medicare prescription drug benefit
must offer seniors the choice of where to meet their prescription
needs, and that includes the right to use their local pharmacies,
where many depend on the health care services and information
provided by community pharmacists they know and trust."
The
White House estimates that seniors who stay in traditional
Medicare will get discounts of 10 percent to 25 percent through
the federal card. Low-income seniors will also get a $600 annual
prescription subsidy.
Seniors
could also enroll in Enhanced Medicare, which HHS said is similar
to plans available to federal employees. That plan would offer a
choice of local health plans, a subsidized prescription benefit
and full coverage for preventive health services. Participants
would pay a portion of costs, but would have catastrophic
coverage.
Enhanced
Medicare, according to the plan, would be administered by a new
HHS agency, the Medicare Center for Beneficiary Choices. .
"The MCBC will designate large, multi-state Medicare
regions," noted the White House, and managed care plans would
submit bids to serve one or more region.
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