Final Stretch, Medicare Part D

With May 15th. still being the deadline for the initial sign-up period for the new Medicare Part D prescription drug program, we’re indeed heading down the stretch in something of a “dead heat.” The program’s start-up has been almost anything but uneventful, and recent articles still say many potentially-qualifying individuals remained unaware that there was a deadline, and that penalties ensued thereafter. Others report that some many find themselves in positions were they’re going to, at least temporarily, lose drug coverage.

As we’re heading down that stretch, U.S. Health & Human Services Secretary Michael Leavitt’s headed out to some 24 cities across the nation promoting the effort to get people signed up. A last-minute crunch is perhaps rightly expected and being prepared for.

The next enrollment period would be November 15- Dec. 31 – with an added 6% charge per month for coverage.

Confusion and unresolved issues remain, though.

A Government Accounting Office report released May 3rd. found that “information provided by the Center for Medicare & Medicaid Services about the complicated new drug benefit was rife with problems, and failed to provide material that was consistently clear, complete, accurate, and usable,” emphasizing a need to extend the May 15th. deadline for enrollment and waiving the late enrollment penalty. (See “highlights” and full-test )

The White House response, the next day, was saying the findings in the GAO report were “inaccurate, incomplete, and outdated.”

There’ve been close to 100 bills proposed in Congress both extending the deadline, and doing away with the penalties, but that eventuality seems remote. HB 1382, submitted back in March 2005, would provide for a one-year extension to the program; HB 4410 would extend the initial enrollment period thru May 15, 2008 and waive penalties for late enrollment before June 1, 2008. Some of the proposals go even further. HB 5263, introduced last week, would “extend the 2006 & 2007 initial enrollment periods, suspend the late enrollment penalty thru Dec. 2007 to permit beneficiaries change enrollment in prescription plans during the first 12 months of enrollment, and prevent changes in formularies other than at the time of open enrollment periods & only with advance notice.”

There are also court cases pending, including a class action suit filed in northern California District Court two weeks ago accusing the Health Department of failing to ensure the poor were properly being enrolled in the new drug program. Proceedings in the case aren’t expected until late July or August (ABC news article)(Complaint )

Financing the program’s an issue as well. For the first time since Medicare & Medicaid’s enactment back in 1965, specific benefits are now being charged to the individual states in phased-down, or “clawback,” as it’s being more popularly known as, contributions. Five states, with another ten backing, filed suit in a case of original jurisdiction in the U.S. Supreme Court on March 3rd., challenging those provisions. Texas, Kentucky, Maine, Missouri, and New Jersey are shown as plaintiff in the case, with Ohio being one of those filing an amicus brief in support. A motion for preliminary injunction was filed March 17th. and is awaiting response.
(Complaint)( Amicus Brief )