Medicare Part D lawsuit against Leavitt settled
SAN FRANCISCO The case of Situ v. Leavitt, which involved low-income dual eligible Medicare beneficiaries suing Health and Human Services Secretary Michael Leavitt regarding poor management of the Medicare Part D prescription program, has been settled.
The plaintiffs had argued that the poor management of the program created ongoing barriers for themselves, by causing delays when the patients signed up for drug plans or when they were forced to switch plans every year due to plans going out of business and new plans starting in their place.
As part of the agreement, the Bush administration will change how HHS and the Centers for Medicaid and Medicare Services will be operated for dual eligible Medicare beneficiaries. Some of these changes for CMS include:
- Speed up the enrollment process for new dual eligibles. Instead of waiting several weeks to process files received from states identifying new dual eligibles, CMS will process these files within one business day of receipt. CMS will also allow states to submit these files more frequently.
- Require plans and CMS Regional Offices to provide additional assistance to beneficiaries whose names are inadvertently missing from pharmacy or plan computer systems. New protocols will shift the burden of proof away from beneficiaries and to providers when eligibility is in question.
- Educate pharmacy organizations about new policies intended to increase protections for dual eligibles who are not automatically enrolled in a plan and, therefore, are unable to obtain medications.
“This settlement agreement is a victory for many of our nation’s most vulnerable citizens,” said National Senior Citizens Law Center Staff Attorney Kevin Prindiville, which was serving as counsel for the plaintiffs. “These individuals have faced life-threatening delays in receiving vital medication. They do not have the means to front the costs of their prescription drugs while Medicare and the plans sort out paperwork. We view the administration’s agreement to this settlement as a sign that it is now committed to providing adequate protections for these beneficiaries.”
California information-sharing bill struck down by Assembly
LOS ANGELES A California bill aimed at sharing people’s prescription medication information with mass mailers did not receive a single vote of support in the Assembly Health Committee after being approved by the Senate on May 29, according to the Los Angeles Times. The bill, SB 1096, was written by Sen. Ron Calderon, D-Montebello, who will most likely not reintroduce it, even though he reserved the right to do so.
In presenting the legislation Tuesday, Calderon described it as a boon to consumers, especially those with chronic medical conditions. He said it would allow drugstores to send letters to people reminding them to take their medication or refill a prescription.
The problem with the bill, besides the fact that the patients did not want their prescription medical history shared with someone other than their doctor, is that the bill did not state who would be paying for the reminder letters and which patients would receive them.
According to the Times, it appeared that pharmaceutical companies were behind the funding in an effort to bring in more money on their respective medicines. Also, another provision stated that people who wanted to not be on the mailers would have to opt-out of the program, instead of opting into the program by stating that they would be okay with their information shared.
CCPA: track-and-trace mandate could cost pharmacies $110,000 per store
ALEXANDRIA, Va. Implementing a track-and-trace system would cost drug store chains $84,000 to $110,000 or more per store in the first year, according to a study that examined the safety of the prescription drug supply chain and the potential effects of a federally mandated system.
The study, released by the Coalition of Community Pharmacy Action, examined the safety of the prescription drug supply chain and the potential effects of a federally mandated track-and-trace system. It also found that existing security measures since 2005, including changes in state laws and steps the chains themselves have taken, have already cut the risk of counterfeit drugs entering the supply chain. The study found no cases of counterfeit drugs in the normal distribution channels since 2005, and most of the problems were from Web sites distributing drugs illegally.
The cost estimate was based on costs of computer hardware software, infrastructure, labor and other resources.
The CCPA is comprised of the National Community Pharmacists Association and the National Association of Chain Drug Stores.