Medicare Rights Center Details Plan To Obama Health Team To Protect Medicare Consumers

Main Category: Medicare / Medicaid / SCHIP
Article Date: 12 Dec 2008 - 2:00 PST

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Quick action is needed by the incoming Obama Administration to enact basic consumer protections under Medicare private health and drug plans, according to a memorandum to the Obama transition team released today by the Medicare Rights Center.

"Senator Daschle and his impressive health care team can tackle the immense challenge of making our fractured, costly and dysfunctional health care system work for all Americans," Medicare Rights Center President Robert M. Hayes said. "From day one, we look to the Obama Administration to reverse the Bush Administration's failure to protect the interests of Medicare consumers. The new president and his health care team should be ready to promulgate sensible rules that, together with smart enforcement, will force improved care and enhanced value from private Medicare health and prescription drug plans."

The Medicare Rights Center's transition memo proposed ten actions that the new leadership of the Centers for Medicare & Medicaid Services can take in the coming months. The recommendations are:

- Ensure that all Medicare "Advantage" health plans provide adequate financial protection for enrollees who have high out-of-pocket costs for medical services.

- Require Medicare Advantage plans that serve people with low incomes or chronic illnesses to provide adequate care coordination.

- Allow state insurance departments a greater role in preventing and punishing abusive marketing by Medicare Advantage plans.

- Prevent pharmacy benefit managers from inflating the price of drugs under the Part D prescription drug benefit.

- Stabilize Part D drug coverage for low-income people with Medicare.

- Ensure that low-income people with Medicare are enrolled in drug plans that best meet their needs.

- Allow prescription drug plans to cover uses of drugs that are supported by clinical evidence in peer-reviewed medical journals.

- Strengthen consumers' ability to appeal when coverage of medically necessary medicines is denied by Part D drug plans.

- Require Part D drug plans to automatically reimburse low-income enrollees for excess premiums and copayments paid.

- Collect data from Part D plans to ensure appeals and transition policies prevent disruptions to drug regimens.

All the transition memo proposals can be implemented by the new administration without changes to legislation. The text of the full transition memo is available here.

To learn more about Medicare consumers' rights and protections, log on to Medicare Interactive Counselor at the Medicare Rights Center's website at http://www.medicareinteractive.org.

Medicare Rights Center is a national, not-for-profit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.

Medicare Rights Center