Pharmaceutical representatives testified before Congress earlier this month about the administrative burden placed on long term care providers, particularly nursing homes, by Medicare Part D, the new prescription drug program. They also said providers are losing money because of the program.
The new drug program was created to give seniors more choices, but it seems to be offering conflicting and confusing choices. For example, Long Term Care Pharmacy Alliance executive director Paul Baldwin testified that in some cases, medications previously covered were no longer covered under Part D.
As a result, pharmacies have to absorb the costs of those prescriptions. Pharmacies and nursing homes end up paying for the drugs because they can’t legally deny medications to recipients and residents. Additionally, Medicare beneficiaries who were automatically enrolled in Part D on January 1 found themselves in multiple drug plans for which they received little information.
Baldwin and other representatives offered suggestions they said would ease the burden and bring down costs. Nursing homes currently are not allowed to advise patients on choosing plans. These facilities should be allowed to discuss options with patients and guide them to plans with the necessary covered drugs.
Providers and recipients seeking help from the Centers for Medicare and Medicaid Services (CMS) often received the wrong information about which prescription drug plans were appropriate, which I blogged about here. In May, the Government Accountability Office issued a 32-page report (PDF) about CMS’s customer service. According to CMS, it is trying to fix the problems.
Sources: United Press International and Axcess News