From Pine View Farm

Venality beyond Words 0

Behind closed doors:

House and Senate GOP negotiators, meeting behind closed doors last month to complete a major budget-cutting bill, agreed on a change to Senate-passed Medicare legislation that would save the health insurance industry $22 billion over the next decade, according to the nonpartisan Congressional Budget Office.


That change was made in mid-December during private negotiations involving House Ways and Means Chairman Bill Thomas (R-Calif.), Senate Finance Committee Chairman Charles E. Grassley (R-Iowa) and the staffs of those committees as well as the House Energy and Commerce Committee. House and Senate Democrats were excluded from the meeting. The Senate gave final approval to the budget-cutting measure on Dec. 21, but the House must give it final consideration early next month.

Meanwhile (from last February):

The White House released budget figures yesterday indicating that the new Medicare prescription drug benefit will cost more than $1.2 trillion in the coming decade, a much higher price tag than President Bush suggested when he narrowly won passage of the law in late 2003.


California, Arkansas and Illinois have joined about half a dozen other states taking emergency measures to help residents struggling to get prescriptions filled under the new Medicare drug program.

California Gov. Arnold Schwarzenegger ordered an emergency plan Thursday allowing the state to pay for the drugs for the next two weeks.


The new Medicare drug benefit went into effect on January 1. During the initial days of this benefit, NAMI is hearing both positive and negative stories from across the country about the initial transition period to the new benefit — especially among low-income individuals with severe mental illness who are “dually eligible” for both Medicare and Medicaid. While some “dual eligibles are getting their prescriptions consistent with the new law — uninterrupted refills at only $1 for a generic medication and $3 for brand name medication, others have experienced severe problems at the pharmacy counter. These problems include:

No electronic record of enrollment in a Medicare drug plan;
Pharmacies charging cost sharing above $1 for a generic drug/$3 for a brand name drug;
Attempts to impose deductibles;
Prescriptions being denied because of exclusion from a plan’s formulary; and
Prescriptions being denied because of “prior authorization” and “step therapy” requirements.

Maybe this should have been tagged under incompetence also.


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