Lincoln to Bush: Fix Medicare Problems Now

Lincoln to Bush: Fix Medicare Problems Now

U.S. Senator Blanche Lincoln (D-Ark.) is calling on President Bush to address several critical issues related to the Medicare Prescription Drug Program so that beneficiaries do not face unnecessary hardship in the coming months.

In a letter sent yesterday to the President, Lincoln said that the resignation of Dr. Mark McClellan, Medicare's top official, presents an opportunity to focus on the continuing problems with the drug program's implementation. Lincoln called on the President to fix several measures before Congress recesses at the end of this month in order to avoid potential problems for beneficiaries. The complete text of Lincoln's letter to President Bush is as follows:

Dear Mr. President:

As you know, on September 5, the Centers for Medicare and Medicaid Services (CMS) Administrator, Dr. Mark McClellan, announced he would leave his post next month. I believe this transition presents an opportunity to address some ongoing concerns regarding implementation of the Medicare Prescription Drug Program. As you search for a successor to replace Dr. McClellan, I encourage you to select an individual who possesses the knowledge and skills that are necessary to succeed in this critical management post and who makes improving the Medicare Prescription Drug Program a top priority.

In the meantime, there are several critical issues related to Medicare Part D that require immediate attention in order to avoid potential problems over the next few months. I do not believe that any of these measures are unreasonable, and have been given considerable attention here in the U.S. Senate. I urge you to seize the opportunity to make them a priority and move these bills before we recess. Not taking immediate action could result in hardship for many Americans. These issues include:

Eliminate Enrollment Penalty: The Medicare Part D prescription drug program is complex, and individuals in addition to low-income beneficiaries should not be penalized for late enrollment. I am a co-sponsor of S. 2810, sponsored by Finance Committee Chairman Grassley, which would amend title XVIII of the Social Security Act to eliminate the months in 2006 from the calculation of any late enrollment penalty under the Medicare Part D prescription drug program. If the late enrollment penalty is not removed, many older adults will be forced to pay a penalty for every month that they are in the Medicare prescription drug plan, causing a major financial burden for these adults in their later years.

Improve Pharmacy Access: Fair dispensing fees for participating pharmacies will help ensure greater access for more beneficiaries. Two key components of the Pharmacy Access Improvement Act of 2006 (S. 2664), of which I am a co-sponsor, requests that the Secretary of Health and Human Services establish reasonable dispensing fees for covered Medicare Part D drugs dispensed by participating pharmacies and requires a prescription drug plan (P.P.) sponsor to encourage generic utilization by paying an increased dispensing fee for generic drugs.

Additionally, some PDS have taken steps that, in effect, limit beneficiaries' ability to obtain extended supplies through retail pharmacies. Some PDS have made their own mail-order pharmacy the only preferred pharmacy for extended supplies; others permit retail pharmacies to provide extended supplies but require the beneficiary to pay higher cost-sharing, consistent with the guidance issued by CMS. I am concerned that these rules may undermine the spirit of the Medicare law's provisions regarding a level playing field between mail-order and retail pharmacies and the Agency's own objective of ensuring reasonable access for beneficiaries.

Assistance for State Outreach and Enrollment: Area Agencies on Aging (AAAS), Native American Aging programs, and State Health Insurance Assistance Programs (ships) have provided counseling on Medicare Part D enrollment without adequate funding. In FY 2006, SHIP programs, of which one-third are operated by AAAS, are funded at $31.5 million. With the exception of a few one-time only grants, these agencies have had to absorb the costs from budgets that are already stretched tightly. I know that in Arkansas more work needs to done, as many people who may be eligible for the low-income subsidy have not signed up for benefits. While the Social Security Administration has processed 67,931 of the 80,987 applications submitted, there are approximately 13,000 individuals who may still be eligible for the subsidy. CMS needs to dedicate funds to these agencies to provide further support and outreach to low-income persons. New funding of at least $30 million should be allocated to the AAAS and Native American aging programs in FY 2007 and $13 million to the SHIPS. This funding would cover about one percent of the cost of performing enrollment assistance and counseling, which costs approximately $100 per beneficiary.

Erroneous Medicare Part D Premium Withholdings: The high number of erroneous Medicare prescription drug refund premiums withheld from Social Security checks is unacceptable. Over 500,000 beneficiaries have had incorrect premiums withheld, with 200,000 cases occurring in August 2006. My state offices have been inundated with constituent calls regarding this problem. For example, one couple enrolled in a particular plan and a few days later decided to switch their plan. CMS has not dropped them from the first plan, nor have they notified Social Security about the change. As a result, Social Security is withholding premiums from the first plan, about $100, and CMS now owes them $900. Additionally, there are another 3,765 Arkansans who have had their premiums refunded who never requested refunds. These types of errors must be remedied to prevent confusion among beneficiaries and communication needs to be enhanced between the agencies and Congress.

I appreciate your immediate attention to these matters. We should not let the opportunity pass to address these important issues in the remaining days of this Congress. I look forward to working with you and the new CMS Administrator in the future to further improve the Medicare Part D program so that it reaches a greater number of older adults.

http://lincoln.senate.gov/press_show.cfm?id=263133