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WYDEN’S “MEND” ACT WILL ENHANCE SENIORS’
MEDICARE PRESCRIPTION DRUG COVERAGE
Drug prices show sharp spike in recent
weeks; bipartisan bill introduced today gives bargaining power
to HHS, can help seniors better afford medicines
February
1, 2005
WASHINGTON,
DC – At a press conference this morning, U.S. Senator Ron
Wyden (D-Ore.) unveiled the bipartisan Medicare Enhancement for
Needed Drugs (MEND) Act, legislation he authored with U.S. Senator
Olympia Snowe (R-Maine) to strengthen the drug coverage offered
to seniors under the 2003 Medicare prescription drug benefit.
The MEND Act directly addresses the crisis of skyrocketing drug
costs in a number of ways, including giving the Secretary of the
U.S. Department of Health and Human Services (HHS) the specific
authority to negotiate lower prices for drug purchases through
Medicare, and requiring ongoing information about savings in various
plans and the prices of prescription drugs across multiple markets.
The bipartisan bill is also cosponsored by U.S. Senators Russell
Feingold (D-Wisc.), Dianne Feinstein (D-Calif.) and John McCain
(R-Ariz.).
“The MEND Act will give
seniors across the country, in rural and urban areas, in both
private plans and Medicare-operated fallback plans, the clout
they need in the marketplace to get a fair deal on the medicines
they need. For the sake of Oregon seniors and millions more nationwide,
it’s clearly time to inject bargaining power and other common-sense
solutions into the Medicare drug benefit,” said Wyden.
The MEND Act repeals Section
1860D-11(I), or the non-interference provision, of the Medicare
prescription drug benefit, which prohibits the HHS Secretary from
negotiating for lower-cost drugs in bulk. MEND grants the Secretary
specific authority to bargain for better prices and improved access
to medicines in the same way that private insurers and private
businesses negotiate for lower costs in bulk. This effectively
levels the playing field for more seniors; the MEND Act requires
the Secretary of HHS to negotiate for “fall-back”
plans, which are Medicare-operated plans designed to give more
choice to seniors who live in areas with limited private options,
and also in any case where a private insurance plan asks for help
in negotiating lower drug prices.
Also in MEND, the Centers for
Medicare and Medicaid Services (CMS) would be required to determine
the negotiated savings received from each plan by the average
Medicare beneficiary. This would help seniors make an “apples
to apples” comparison to determine which plan provides the
best savings. This information would be shared with all beneficiaries
during the annual fall enrollment period.
Additionally, the MEND Act writes
into law a request that Wyden and Snowe made last December for
the Government Accountability Office (GAO) to track ongoing changes
in drug prices from 2000 to 2003. After conducting that review,
the GAO will continuously review the retail cost of prescription
drugs used most by seniors through April 1, 2006. This step is
essential to ensure that pharmaceutical companies do not arbitrarily
increase drug prices as the Medicare drug benefit takes effect;
a Wall Street Journal report has suggested that a sharp spike
in some drug prices in recent weeks may be partly in anticipation
of the drug benefit. MEND also requires GAO to compare drug prices
negotiated by DOD and the VA against other privately run systems,
providing critical information on whether the government or private
plans negotiate for the best prescription drug prices.
Lastly, in an effort to confront concerns that the Medicare prescription
drug benefit restricts Medigap coverage, this legislation directs
the Secretary of HHS to work with the National Association of
Insurance Commissioners to conduct a review of the changes to
the Medigap policies in the new drug benefit to evaluate its impact
on Medicare beneficiaries. Medigap coverage is any private health
insurance purchased by individuals to supplement services not
covered by Medicare (e.g., deductibles, co-payments, and outpatient
prescription drugs).
In December 2003, Wyden vowed to strengthen the saving power of
the new Medicare prescription drug benefit for seniors. He and
Snowe have a long history together promoting bipartisan, common-sense
legislative solutions on health care; in 1999, they introduced
the first bipartisan Medicare prescription drug bill known as
the SPICE Act. That same year, as members of the Senate Budget
Committee, they established the first reserve fund to set aside
$40 billion for the creation of a drug benefit.
The MEND Act is expected to
be referred to the Senate Committee on Finance, of which Wyden
is a member.
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