Some major drug companies are unveiling plans to help needy Medicare patients who fall into the doughnut hole.  Up until this year, many such programs provided expensive prescription drugs at little or no cost to seriously ill patients.  Drug companies suspended the “patient assistance programs” at the start of 2006 because they were uncertain if they would be legal under Medicare Part D, abruptly leaving chronically ill beneficiaries with thousands of dollars in new out-of-pocket drug costs.  Recently, several drug manufacturers announced they are seeking approval from the government for a new program.

TSCL is also concerned that as many as 4 million beneficiaries, who are eligible for Part D did not enroll by the May 15th deadline, according to estimates by the Centers for Medicare and Medicaid Services and the Congressional Budget Office.  Persons who missed the deadline and enroll later will be subject to a penalty that will be applied to their premium every year for the rest of the time they remain enrolled in Part D.  TSCL supports bipartisan legislation that would allow beneficiaries to enroll through the end of this year without penalty.

Of those who did not enroll, 3 million are believed to be low-income beneficiaries who qualify for “Extra Help,” special assistance that pays most of their drug costs.  In a surprise reversal of policy, the government recently announced that low-income beneficiaries found eligible for the “Extra Help¸” program could enroll after the May 15 deadline without incurring a penalty for late enrollment.  For more information about this see “Extra Help Could Help Notch Babies Pay For Their Prescription Drugs” on page two, and “Is Medicare Part D “Extra Help” Worth The Hassle?” on page four of this newsletter.

Although hundreds of bills have been introduced, Congress has taken no action this session to correct problems plaguing the new program.  TSCL continues to work for simplification of the program and supports legislation that would cut drug costs by allowing the importation of less costly FDA approved prescription drugs from Canada and certain other nations.

Sources:  “Most Seniors Enrolled Say Drug Benefit Saves Money,” Birnbaum and Deane, The Washington Post, April 12, 2006.  Letter to Representative Fortney Pete Stark, Congressional Budget Office, May 1, 2006.  “Drug Plan Surprise,” Letter to the Editor, The New York Times, May 24, 2006. “Companies Propose New Medicare Drug Aid Plans in U.S.,” Lisa Richwine, Reuters, May 10, 2006.

July 2006