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Larson Moves for Greater Beneficiary Protections under New Medicare Drug Law

Location: Hartford, CT


HARTFORD, CT - Congressman John B. Larson (CT-01) on Tuesday called for extending for two years the enrollment period that seniors and people with disabilities have to sign up for a new prescription drug plan as part of a bill he has put forward to inject greater fairness in the new federal coverage program.

"I have heard from an outpouring of seniors that navigating this labyrinth of plans is hopelessly confusing," Larson said at a press conference at the Legislative Office Building, supported by several state legislators and advocates for seniors and people with disabilities. "We ask a lot of our seniors and they have given much. We shouldn't be burdening them with a so-called benefit that requires that they be an actuary, an accountant and an attorney in order to interpret these plans or hire them to. Six months is simply not enough time to make an informed choice. It's certainly not enough time to reach and counsel more than 42 million beneficiaries."

Larson acknowledged that while he voted against the Medicare Part D bill because of its numerous inadequacies, he considers it an obligation to ensure that Medicare beneficiaries are provided the fullest protections and flexibility possible so they can take advantage of the discounts available to them under the new plan.

With that goal, Larson's proposal, the Medicare Prescription Drug Flexibility For Seniors Act (H.R. 4410), would:

Lengthen the open enrollment period to two years, giving beneficiaries until May 15, 2008 to choose to make the best choice for them. Penalties would be waived until June 1, 2008.

Eliminate one-sided lock-in. Medicare Part D plans can change the drugs on their formulary during the course of the year with 60 days notice to plan members. Yet, beneficiaries are severely limited in their ability to change plans or opt out. The bill gives plan participants a 60-day window to change plans if the plan sponsor alters its formulary.

Penalize retirement health plans that provide misleading information. Sponsors of beneficiaries' existing plans (such as those sponsored by employers or unions) are required to disclose whether they offer coverage that is comparable to that offered under Part D. This is critical information for seniors because delaying enrollment can lead to late enrollment penalties or unnecessary enrollment in a Part D plan. The bill includes a fine up to $10,000 for each false or misleading disclosure.

Enrollment began Nov. 15. Across the country, beneficiaries are confronted with up to 60 plans. In Connecticut, they have to choose among 44 plans that differ vastly in premiums and co-payments, the number and types of drugs covered and participating pharmacies by May 15, 2008, after which time they will be assessed a lifetime late penalty in the form of higher monthly premiums to sign up. Some of the plans offer only drug coverage while others offer both medical and drug coverage.

Larson pledged to persevere with efforts to replace the hodgepodge of plans with the program that should have been adopted in the first place: having the federal government negotiate discounts directly with the pharmaceutical companies as it does with the Department of Veterans Affairs and other countries do.

"Seniors have been turned into refugees from their own health care system," he said. "The prime beneficiaries of Medicare Part D are the pharmaceutical companies and insurers receiving taxpayer subsidies. Seniors and people with disabilities deserve a simple straightforward program that delivers the deepest discounts possible. This impossibly convoluted system comes nowhere close. It is still cheaper for seniors to buy their drugs from Canada. They should not have to buy their drugs from a foreign country nor should they have to decide between essential prescriptions and heat for their homes or food for their stomachs."

Larson was joined in introducing his bill by a dozen co-sponsors, including Congresswoman Rosa DeLauro (CT-03.)

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