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 Orange County Area Health Education Center (AHEC) 2333 North Broadway, Suite 440 Santa Ana, CA 92706 |
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FROM THE COMMITTEE ON WAYS AND MEANS Stark Announces a Hearing on Beneficiary Protections in Medicare Part DHouse Ways and Means Health Subcommittee Chairman Pete Stark (D-CA) announced that the Subcommittee on Health will hold a hearing on protecting beneficiaries in Medicare Part D plans. The Medicare Modernization Act of 2003 (P.L. 108-173) created a new Medicare Part D voluntary prescription drug program for beneficiaries. Since January 2006, beneficiaries have had the opportunity to enroll in private-sector prescription drug plans. As of March 2007, 16.9 million beneficiaries were enrolled in stand-alone prescription drug plans (PDPs) and another 7.1 million were enrolled in Medicare Advantage plans offering prescription drugs (MA-PDs). Millions more Medicare beneficiaries receive drug coverage through other sources like the Department of Veterans’ Affairs or a former employer. In nearly every state, beneficiaries must choose among more than 50 different drug plan options offered by eight to 40 different plan sponsors. Each plan can offer a unique benefit structure as long as it is actuarially equivalent to the standard benefit. This forces beneficiaries to compare widely varying premium, cost-sharing, formulary, and utilization management designs. Beneficiary confusion about the number and type of plan offerings has led to calls for prescriptiondrug plan standardization, similar to the Medigap market, or for the creation of a drug program, administered by Medicare, that competes with private sector plans. Implementation of the new Part D drug program was fraught with problems. Beneficiaries had trouble navigating the multitude of drug plan choices. Even after signing up, many still struggled to get their drugs at the pharmacy counter. While many of those early problems have been fixed, Congress has an obligation to make sure Part D runs smoothly and beneficiaries are adequately protected. Advocates for Medicare beneficiaries have expressed ongoing concerns with enrollment periods and practices, formulary requirements and exceptions, appeals and grievance procedures, marketing abuses and beneficiary education. In announcing this hearing, Chairman Stark said: “Part D has been up and running for a year and a half, and Congress has yet to look at any changes necessary to protect beneficiaries in this new program. It’s time to shine the light on Part D and see if there are some simple things we can do to improve the program for beneficiaries and taxpayers.” The horrible fiasco of so-called “Medicare Reform” has created enormous hardship and distress for tens of thousands of Medicare recipients. Many fragile, elderly recipients and disabled persons have had to struggle, as never before, to figure out the complicated, lunatic marketplace, where an Einstein would be hard-pressed to choose among “50 different plan options offered by eight to 40 different plan sponsors.” At the same time, the incredibly callous and disgraceful “donut hole” in the law and the prohibition on Medicare to negotiate fair drug prices create an uneven playing field, favoring the so-called “private sector” insurance companies and plans, which are also subsidized to the tune of millions of dollars of our money! Surely our legislators, including Mr. Fortney “Pete” Stark, can do more than “shine a light” and do some “simple things.” It’s time for universal health insurance, and control of drug prices, Mr. Stark! COPYRIGHT © 2000-2008 Health Care Council of Orange County Web Site maintained by
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