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Medicare Drug Benefit

Congress could improve the newly created Medicare prescription drug benefit by applying the lessons of welfare reform, according to an excellent new article by Paul Barringer. In American Outlook, the Hudson Institute's quarterly journal, Mr. Barringer lays out what made welfare reform successful: ● Pay for performance: bonuses for performing well...
The Centers for Medicare & Medicaid Services (CMS) today released the final rule governing the new Medicare prescription drug benefit. To help folks understand the 1,162-page final rule, CMS created a variety of fact sheets, timelines, and other background materials to help stakeholders understand the extraordinarily complex drug benefit: ● Overview...
Some legal gurus are questioning the constitutionality of a key provision of the Medicare prescription drug benefit: the so-called "clawback" provision that requires states to send the federal government cash to help cover the cost of drugs for dual eligibles. The mandatory payments are enormous - $6 billion in...
When the Medicare prescription drug benefit begins on January 1, 2006, about seven million beneficiaries face more restricted drug formularies. Currently, these "dual eligible" individuals receive their drug benefit through state Medicaid programs, which offer more liberal formularies than what will be expected of the new Medicare drug plans. In...
New evidence on the high incidence of preventable, often deadly drug errors in nursing homes raises serious implications for the new Medicare prescription drug benefit. Each month, one in ten nursing home residents suffer a medication-related injury, according to a new study in the American Journal of Medicine. The lead...
The supply chain for prescription drugs is as complex as it is important. It represents a fascinating, continuously evolving maze of players, relationships, and processes from manufacturers all the way to individual patients. With Medicare's new approach to Part B drug reimbursement, the upcoming Medicare Part D drug benefit, increasing...
Medicare observers expect heavy competition for drug plan contracts with the Centers for Medicare & Medicaid Services (CMS). It now appears CMS will receive several hundred applications, including applications from major insurers offering drug benefit packages in every state. Since adoption of the Medicare Modernization Act (MMA), most observers -...
In 2005, state Medicaid programs will pay for over 18 percent of the nation's quarter trillion dollar pharmaceutical market. Thanks to an excellent new analysis by Jim Verdier and colleagues at Mathematica Policy Research, we have new insights into cost and use patterns in Medicaid. Some highlights: ● Average monthly Medicaid...
Many Americans living with HIV/AIDS receive critically important prescription drug coverage from state Medicaid programs. For these beneficiaries, Medicaid typically offers broad formularies, low cost sharing, and access to a large network of pharmacies. However, about 50,000 to 60,000 persons with HIV/AIDS will be losing Medicaid drug coverage on January...
The new Medicare prescription drug benefit presents many challenges to the nation's seven million dual Medicare-Medicaid eligibles. On January 1, 2006 they must move from broader, more flexible Medicaid drug coverage to the narrower, extraordinarily complex Medicare drug benefit. Among those in jepordy are about a half million frail...

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