Kaiser Daily Health Policy Report Highlights Medicare News Related To Independent Pharmacies, Private Health Plans, Preventive Care

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Public Health;  Pharmacy / Pharmacist;  Health Insurance / Medical Insurance
Article Date: 16 Jul 2007 - 17:00 PDT

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Summaries of several recent developments related to Medicare appear below.

• Independent pharmacies: The implementation of the Medicare prescription drug benefit in 2006 "made pharmacies of all sizes far more dependent on reimbursements from pharmacy benefit managers," and PBMs "have put the squeeze on independent pharmacies," the Orlando Sentinel reports. According to the National Community Pharmacists Association, 1,152 independent pharmacies closed in 2006. Independent pharmacies maintain that reimbursements from PBMs often do not cover their costs and often are delayed by months (Wessel, Orlando Sentinel, 7/11).
  
  
• Medicare Advantage: CMS late last month drafted new guidelines that will allow beneficiaries enrolled in private Medicare Advantage plans to withdraw from the plans in cases in which sales agents used potentially illegal or improper practices to enroll them, the Tampa Tribune reports. The guidelines, which instructed regional CMS offices to consider such cases "high priority," will eliminate a "lock-in" requirement for MA plans that took effect on March 31 for the remainder of the year. The CMS press office, which released the rules to the Tribune on Friday, began to train telephone operators at 1-800-MEDICARE after the agency drafted the guidelines (Gentry, Tampa Tribune, 7/11).
  
  
• Preventive services: Fewer than half of the 43 million Medicare beneficiaries make full use of the preventive services offered by the program, Herb Kuhn, acting deputy administrator of CMS, said on Monday during a meeting in Kansas City, Mo., the Kansas City Star reports. Medicare in recent years has begun to offer flu vaccinations, physical examinations, mammograms, smoking cessation counseling and other preventive services. During a meeting of more than 100 physicians, hospital and medical school representatives, and state and local health officials at the University of Missouri-Kansas City, Kuhn discussed proposals to help promote use of the preventive services offered by Medicare (Bavley, Kansas City Star, 7/10).

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