News

  • Issues Totalization Agreement

    Send an email to your Members of Congress. This is an election year, and the last thing they want to hear is that health insurers are blaming COVID-19 for the steep price increases. You can get email addresses on TSCL's website here: http://wfc2.wiredforchange.com/o/8854/p/dia/action4/common/public/?action_KEY=10560. Or, you can look up your Representative and send emails at: www.house.gov and Senators at: www.senate.gov. .Should seniors with Medigap supplements that provide "first dollar coverage" be required to pay more up-front? Should Medicare continue to pay for services based on medical necessity, or should the government change to a system "based on evidence of the value of services?" Congress may be debating these questions this month when the Medicare Payment Advisory Commission (MedPAC) issues its June report to Congress. The idea is to make Medicare beneficiaries "think twice" before scheduling doctor, outpatient services, or hospital stays in order to reduce government spending on Medicare. .The act also recalculates COLAs so future changes would be based on the price of goods and services seniors actually buy, like medications, by using a formula known as Consumer Price Index for the Elderly (CPI-E). Currently, the COLA is based on CPI-W, which evaluates the entire economy, including infant and toddler apparel, nursery care, toys and school fees. … Continued

  • Category Issues Medicare Part D Articles Page 7

    One new cosponsor – Rep. Denny Heck (WA-10) – signed on to Rep. Allyson Schwartz's (PA-13) Medicare Physician Payment Innovation Act (H.R. 574) this week, bringing the total up to thirty-three. The bill, if signed into law, would repeal and replace the faulty formula that is currently used to determine reimbursements for physicians who treat Medicare patients. .You don't need to be a doctor to understand that Medicare-for-all would mean access to quality health care for none. So, as presidential candidates continue their road trip to ruin for rural America, remember that the hollow promises of a trillion government-run proposal would disproportionately affect the families who work every single day to feed and clothe you and your families. .If signed into law, the Social Security Fairness Act would repeal the windfall elimination provision (WEP) and the government pension offset (GPO), which have long prevented certain civil servants from receiving the full Social Security benefits they have earned. TSCL believes these two provisions should be repealed, and we were pleased to see support grow for the Social Security Fairness Act this week. … Continued

Check to see if Eliquis is covered by your drug plan and the cost sharing for the tier in which it is listed. Many drug plans have five tiers covering preferred generics, generics, preferred brands, non-preferred brands and specialty drugs. Check to see where Eliquis fits in on these tiers (probably preferred or non-preferred brand). It's not uncommon for insurers to move a drug from preferred brand to non-preferred brand status, causing you to pay more out-of-pocket. For example, your plan in 2019 may have charged a co-pay of for preferred brands, but if Eliquis was moved into a non-preferred tier in 2020 you might have to pay 50% co-insurance or about 5.00. .At the time of writing this week's legislative update, the bill had not yet been approved on the House floor. However, its passage is expected by early next week. Despite bipartisan support in the House, its prospects in the Senate remain uncertain. Lawmakers in that chamber have not yet acted on their version of the bill (S. 141). .The "Doc Fix" .Senate Subcommittee Considers Family Leave Proposal .The conclusions of this study were echoed by a different study published in the medical journal Neurology. .Sources: "Verifying Eligibility for Certain New Tax Benefits Was A Challenge for the 2010 Filing Season," Treasury Inspector General, September 30, 2010, Ref. No. 2010-41-128 .Key Social Security Bill Re-Introduced .Members of the committee questioned several witnesses at Thursday's hearing, including Dr. Janet Woodcock (Director at the Center for Drug Evaluation and Research at the Food and Drug Administration), Nancy Retzlaff (Chief Commercial Officer of Turing Pharmaceuticals), and Martin Shkreli (founder and former Chief Executive Officer of Turing Pharmaceuticals). .Although no other generation has yet been affected by a similar Notch, that could change in the future. Congressional inaction on Social Security's long-term financing problems could give birth to a whole new generation of Notch Babies. During recent hearings on the need for making Social Security more sustainable as Baby Boomers near retirement, David Walker, the Comptroller General of the United States, confirmed this saying "Doing nothing means that we are going to head to a precipitous decline in benefits. Remember the Notch Baby problem?" he asked. "This would be a Notch Baby problem magnified multiple times and it should not be allowed to happen." (10)