If Part D drug coverage is going to win over seniors, then much more needs to be done to ensure satisfaction with the program.  We've heard from many of you who encountered a wide variety of problems with Part D.  Some of you are outraged over the complications of enrollment and the overall costs associated with Part D.  One irate senior said, for example, "Please help the seniors take action and trash this new Medicare Prescription Plan D.  The insurance and drug companies are benefiting from this plan-not seniors."

So far the only action Congress has taken is a budget resolution that doesn't carry the authority of law.  Senators voted earlier this year to authorize the government to extend the Part D Initial Enrollment deadline for enrolling without penalty.  In addition, the measure gave the government power to negotiate prices with drug companies.  But Congress has yet to take any real action.  That could change, however, as lawmakers hear from you.

Already, the federal government has heard so many complaints that it recently announced an important new protection for Medicare Part D beneficiaries.  The Centers for Medicare and Medicaid (CMS) issued a new policy that protects beneficiaries against the sudden loss of coverage for the drugs they are taking.  Under the policy, while insurers can still change their list of covered drugs or formularies, if they drop any drugs or impose new restrictions they must exempt enrolled beneficiaries who are now taking those drugs for the remainder of the plan year.

Under the previous policy, drug plans could drop coverage or impose new restrictions as often as they wished, but most beneficiaries were locked into their drug plan for the full year.  In a memo to insurers CMS said, "Medicare beneficiaries select Part D plans, in part, based on the formulary that is marketed during open enrollment and therefore have a legitimate expectation that they will have continuing access to coverage of the Part D drugs they are using throughout the plan year."

TSCL believes this protection should have been obvious to the Administration and elected lawmakers to begin with.  Nevertheless, CMS is to be thanked for exercising its regulatory powers to protect beneficiaries and encouraged to continue resolving Part D complications.

Meanwhile, TSCL is working with Members of Congress to find comprehensive solutions to simplify and fix problems of the overly - complex program.  If you are having any problems with your Part D coverage, we urge you to contact your Members of Congress and let them know.  Every Member of Congress has constituent service staff that can assist in resolving problems with your Medicare, Social Security and other government benefits.  Contact your Member of Congress.

Source: "Medicare Rule Guarantees Continuity of Drugs," Robert Pear, The New York Times, April 27, 2006.  "Ideas To Fix Part D Lack Real Push," Saul Friedman, Newsday, March 18, 2006.

June 2006