According to a Government Accountability Office (GAO) released last month, the Centers for Medicare and Medicaid Services (CMS) may have made $90 million worth of "questionable" payments to Medicare Part D contractors hired to help launch the program. (Kaiser Network) Some payments didn't comply with terms of the contracts, the GAO found. Jeff Nelligan, CMS spokesperson, said launching the Part D program "required some contract decisions outside of standard policy." You may download the … [Read more...] about GAO Releases Reports on Medicare Part D and SCHIP

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According to a new study published in the Health Affairs journal, Medicare Part D has "dramatically reduced" the number of beneficiaries caught in the coverage donut hole. The donut hole, also known as the coverage gap, is the period of time during the year when a beneficiary is not covered and is responsible for paying drug costs out-of-pocket. Over 16,000 seniors were surveyed last fall, and a quarter of respondents said they spent $100 or more out-of-pocket on Part D drugs per month, and 8 … [Read more...] about Number of Beneficiaries Caught in Coverage Gap Reduced, Study Says

Earlier this week, the Centers for Medicare and Medicaid Services (CMS) announced that it will limit Medicare coverage for anemia medications in cancer patients. CMS will cover medications to treat anemia caused by chemotherapy but won’t cover medications for anemia caused by cancer. (Kaiser Network) Roger M. Perlmutter, a physician and spokesman for the drug company Amgen said, "The coverage restrictions placed on the FDA-approved indication have no scientific basis and are incompatible … [Read more...] about Medicare News: Anemia Treatment, Off-Label Use Issue

Earlier this month, the U.S. House of Representatives passed a bill that would require the government to negotiate Medicare Part D prescription drug prices with drug companies. (See Congress Debates Medicare Part D Drug Price Negotiating) Last week, the measure failed to receive enough for votes for a floor debate in the Senate. (Medical News Today) Those who oppose the bill fear that requiring the government to negotiate instead of allowing the market to dictate drug prices will stifle drug … [Read more...] about Medicare Prescription Drug Negotiation Bill Stalls in Senate

All 50 states, the District of Columbia, Puerto Rico, Guam, the Virgin Islands will share $30 million in grant money to provide health insurance counseling services to Medicare beneficiaries, according to the Centers for Medicare and Medicaid Services. The State Health Insurance Assistance Programs, or SHIPs, will help beneficiaries figure out which insurance coverage is best for them. The program should be quite helpful for Medicare Part D enrollees. Under SHIPs, counseling will be more … [Read more...] about States To Share $30 Million For Health Insurance Counseling

The Centers for Medicare and Medicaid Services (CMS) announced that payment rates for Medicare Advantage plans will increase by 3.5 percent in 2008. (CQ Health Beat News) Medicare Advantage plans offer beneficiaries the traditional fee-for-service program with the option to receive Medicare through private insurance plans like health maintenance organizations and preferred provider plans. CMS also announced updates to Medicare Part D. The new annual percentage increase used for updating … [Read more...] about Medicare Advantage Payment Rates To Increase

Medicare Part D recipients who are qualified kidney dialysis patients will have extra assistance getting bone disease Medicare Part D prescription drugs. (Medical News Today) The American Kidney Fund (AKF) may give eligible patients up to $2,000 a year in drug assistance funds. These grants will help cover “donut hole” costs for recipients caught in the coverage gap. AKF CEO LaVerne A. Burton said, “Because they take so many prescription medications, many dialysis patients have … [Read more...] about Funds for Kidney Patients Under Medicare Part D

In an effort to extend federal subsidies for Medicare Part D to more low-income beneficiaries, Congressman Lloyd Doggett of Texas seeks to revise the asset test for receiving such subsidies. (Kaiser) Doggett introduced a measure that would extend subsidies to about 3.27 million people currently qualified for but who don’t receive subsidies. One way the bill would accomplish this goal is to exclude certain financial assistance from adult children of recipients as “income” when … [Read more...] about Lawmaker Proposes Changes to Asset Test for Medicare Part D