Rep. Davis Speaks Up for Seniors

Davis calls on CMS to clean up the Medicare prescription drug program.

 

WASHINGTON, DC – Today, Congressman Jim Davis confronted the Centers for Medicare and Medicaid Services (CMS) Administrator Mark McClellan about persistent problems with the new Medicare prescription drug benefit.  Dr. McClellan was testifying about Medicare Part D before the House Energy and Commerce Subcommittee on Health, on which Rep. Davis serves.

 

Davis highlighted continued enrollment difficulties for low income Medicare beneficiaries, problems with pharmacy reimbursements and low enrollment numbers.  Davis asked Dr. McClellan to respond to questions about the impact of these problems on Florida’s beneficiaries and pharmacies, as well as CMS efforts to repair the Part D benefit.

 

“The Medicare prescription drug program was supposed to help America’s seniors, not hurt them,” said Congressman Jim Davis.  “Yet many of Florida’s seniors and disabled are still struggling to get their prescriptions under Medicare Part D and many more are still so confused by the program that they don’t know whether to enroll or not.  To make matters worse, some pharmacists are having so many problems getting reimbursed by the new drug plans that they are talking about turning away all Medicare beneficiaries.  These problems deserve immediate action.”

 

Rep. Davis opposed the Medicare Modernization Act, which created Medicare Part D.  However, since the law’s enactment, Davis has worked to fix the program, endorsing a bill to delay the deadline for enrollment so seniors have more time to make sense of the confusing drug plans, legislation to allow the Administration to negotiate with drug companies for lower prices on the medications used by Medicare beneficiaries, as well as a bill to ensure states are fully reimbursed for covering the cost of prescriptions for low-income seniors who have been turned away from the Medicare drug plan.

 

Below is Rep. Davis’ statement.

 

Thank you Chairman Deal and Ranking Member Brown for holding such an important hearing that affects so many of our seniors and disabled. As we all know, the implementation of the new Medicare Part D drug benefit has gotten off to an extremely rocky start. Numerous problems have kept low-income seniors and individuals with disabilities from receiving their life-saving medications, leaving them to depend on a family member for coverage, pay more for their medications or completely forgo the medications they need. These problems have lead 27 states, including my home state of Florida, to pick up the cost of these beneficiary’s medications. 

 

As it should, the Centers for Medicare and Medicaid Services (CMS) has stepped up to reimburse states until March 8, 2006. My concerns remain, however, that March 8th will come and go and the dual eligible beneficiaries will still be facing the same enrollment eligibility problems when they come to pick up their drugs. What steps has CMS taken to ensure that the March 8th deadline will be met with a success? Will CMS continue to reimburse states if the problems remain on March 9th?

 

Although CMS is working on enrollment eligibility problems, I am concerned that there continues to be reimbursement problems for pharmacists, particularly independent community pharmacists. I have learned that many are simply not getting reimbursed by Part D drug plans.  In some cases, this problem is forcing pharmacists to take such drastic measures as closing their doors to all Medicare beneficiaries. For example, in my home state of Florida, Carrabelle Medical Pharmacy, a community pharmacy in the Panhandle and the only one in town, will begin turning away Medicare patients next month because HMO plans are not paying promptly and in some cases not paying at all. Carrabelle Medical Pharmacy also services the Assisted Living Facility, which will now, unfortunately, have to go to the next town, 45 minutes away, in order to get their Medicare beneficiary’s medications.

 

If pharmacies are not reimbursed promptly, we will see more and more deny service to Medicare patients or, worse yet, close down all together, leaving America’s small communities in dire straights. I urge CMS to work with the drug plans and see that our pharmacists are reimbursed promptly.

           

CMS has the authority to sanction any Part D plan for failure to comply with contract requirements. Sanctions can include a written notice of warning, suspension of enrollment of Medicare beneficiaries, suspension of Medicare payments and suspension of plan marketing activities. Has CMS taken any of these steps as to HMO companies that have not reimbursed pharmacies? If not, why not? 

 

Dr. McClellan, I am further concerned about the enrollment numbers of the new drug benefit. The US Department of Health and Human Services recently announced that, as of February 13, 2006, 18 million people with Medicare have yet to enroll in Medicare Part D.  Over a million of them are in my home state of Florida.  Lower than expected enrollment in Part D plans could have a significant impact on plan stability over time and on the overall cost of the program. It, further, has an effect on the amount that beneficiaries pay in monthly premiums over time. 

 

While the implementation of the new Medicare Part D drug benefit got off to a shaky start, CMS may, if they choose, be able to solve some of these problems administratively. In the meantime, I hope that Dr. McClellan will voice his support for legislation I have cosponsored to extend the deadline for enrollment so seniors have more time to make sense of the confusing drug plans.

 

That said, the problems we are facing today are only a glimpse of what we may face when the major Medicare changes in 2010 take place. Congress and this committee must begin addressing the long term problems with this program. One important step we should take is to allow the Secretary of Health and Human Services to negotiate with drug companies for lower prices on the medications used by Medicare beneficiaries.

 

This is a very important issue to Florida’s seniors and disabled individuals. Due to the time constraints in the Health Subcommittee on Energy and Commerce, today I will be submitting questions to Administrator McClellan and asking for a written response. I look forward to working with CMS and my colleagues on ways to make sure that Medicare Part D provides a meaningful drug benefit.