Today the Dept of Health and Human Services announced that Clawback bill will be lower than expected as a result of higher savings from the implementation of the Part D drug benefit. CA payment is estimated to be reduced by $113.2 million, HI $2.1 million, NV $2.2 million, and AZ $5.6 million. PRESS RELEASE...
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Attached is a PDF file from CMS: “This table provides Part D coverage clarifications for specific products/drugs/drug categories in accordance with statutory and regulatory requirements for Part D drugs. This is not an exhaustive list but only addresses those products/drugs/drug categories that have been the subject of frequently asked questions. Specific products not identified...
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A coalition of drug manufacturers is working on a plan to help millions of low-income seniors to pay for drugs when they enter Medicare’s so called “Doughnut Hole.” The Doughnut Hole is the coverage gap when a beneficiaries is responsible for drug costs when their total is between $2,250 and $5,000 annually. The government...
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On a January 24, 2006 conference call Craig Miner and Lawrence Kocot issued guidance on how plans should and should not be determining drug coverage under Parts B and D. “Part D plans should not be requiring a Part B rejection as their first step before they’ll start thinking about covering it under Part...
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We have stayed away from repeating the never ending list of media stories about the failure of the Part D implementation…however Matthew Holt at TPM Café has done a very good job reviewing a Kaiser Family Foundation round table discussing the challenges of the Part D implementation. There is both a video and transcript...
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The Los Angeles Times is reporting that California and four other states plan to file a lawsuit against the federal government alleging the formulas used to calculate the costs of duel eligible drug benefits that states will pay back to the federal government are inflated. According to the Times, at least 15 governors have...
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HHS Secretary Mike Leavitt today released a one-month progress report on the Medicare Prescription Drug Benefit that takes a hard look at what is working and what needs to improve. The report details action steps HHS and health plans are taking, such as extending transition coverage for a beneficiary’s current drugs to 90 days...
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Dear Health Care Professional:The new Medicare Part D prescription drug program is the single biggest change to Medicare since the program began 40 years ago and one which has been long overdue. But adding a benefit as significant as the new Medicare prescription drug program, which affects millions of individuals, involves some start-up challenges....
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Following is a brief overview of the stakeholder conference call lead by Jeff Flick today: States On Track To Federal Part D Reimbursement – The Federal Government is moving to quickly provide a process to reimburse states who have stepped up to be the payer of last resort for duel Medicare beneficiaries who have...
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In this article The Wall Street Journal outlines the aggressive land grab going on right now in the Medicare marketplace as plans use Part D enrollment to capture new applicants and then attempt to migrate them to a full Medicare Advantage program. Also, the article discusses AARP’s influence on the senior population and the success some...
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