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Medicare Officials Back Away From Changes To Prescription Drug Plan

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Another element of the proposed rule would allow insurers to offer no more than two prescription drug plans – one basic plan and one enhanced – in the same service area. The health law’s ongoing closing of  the Part D “doughnut hole,” the gap in coverage where seniors pay the full cost of coverage before the plan’s catastrophic cap kicks in, “has reduced the need for plans offering enhanced benefits,” according to CMS. The agency says that each region of the country now has on average nearly three dozen plans and reducing that would help give beneficiaries more clarity about the differences among plans. Critics of the proposal said it would limit seniors’ choices for coverage.

CMS’ plan was attacked on several fronts. A coalition of more than 370 groups representing seniors, patients, health care providers and employers wrote a letter to Tavenner in opposition. A bipartisan majority of the Senate Finance Committee told  Tavenner they were “perplexed as to why [CMS] would propose to fundamentally restructure Part D by requiring immediate, large-scale changes to the program that have direct consequences for beneficiaries.”  Republicans on the House Energy and Commerce panel sounded similar concerns. And, Rep. Renee Ellmers, R-N.C., a member of the House leadership team, introduced legislation that would stop CMS from moving forward with the rule’s prescription drug provisions. The bill is scheduled for a floor vote Tuesday.

Rep. Sander Levin of Michigan, the ranking Democrat on the House Ways and Means Committee, said the administration’s decision to not “finalize the most controversial proposals in the Part D proposed regulation shows they have listened to stakeholder comments.” He suggested that Ellmers’ bill “would be a gross overreach.”

Some congressional Democrats, facing a tough  midterm election battle, were nervous that a battle on changes to the Medicare drug program could make them even more vulnerable.

Republicans have made repeal of President Barack Obama’s health care law central to their campaign to take control of the Senate and keep the House in the fall elections. The idea of eliminating some Part D plans because they are duplicative of current offerings — CMS’s rationale for the proposed change — has helped Republicans revive criticism of the president’s “if you like your plan you can keep it” pledge on the health law.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Mon, Mar 10 2014

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