News in brief - Aug. 11, 2003

Lawmakers agree on red-tape reduction in Medicare bill - Congress flooded with Medicare prescription drug studies - States pass a flurry of tort reform legislation

Lawmakers agree on red-tape reduction in Medicare bill

House and Senate negotiators working to fuse two Medicare reform bills into a single package have reached an agreement on the regulatory relief provisions to be included in the final measure. The provisions, which were passed by both houses of Congress, are aimed at reducing the paperwork burden for physicians and other practitioners while offering them greater audit protections and rights to appeal.

The final bill, if passed, also would establish a process through which beneficiaries and their doctors could find out in advance whether certain items and services are covered by Medicare. Physician groups, including the AMA, have pushed for many of the reforms for several years but were unable to get the measure through the Senate until this year.

Congress flooded with Medicare prescription drug studies

As Congress toils to reach a consensus on a Medicare outpatient prescription drug benefit, lawmakers have been inundated with new research on seniors' ability to pay for their medications.

A study published in Health Affairs found that the percentage of Medicare beneficiaries 65 to 69 with employer-sponsored health coverage fell from 46% in 1996 to 39% in 2000. Researchers found a similar decline in employer-sponsored drug benefits, from 40% to 35% within the same time frame.

The Employee Benefits Research Institute estimated that between 2% and 9% of Medicare beneficiaries with employment-based drug coverage would lose those benefits if a Medicare drug benefit is enacted.

Elderly African-Americans are twice as likely as Caucasians to say they cannot afford prescription drugs, according to a survey by the Center for Studying Health System Change. One in six African-American seniors did not fill at least one prescription in the last year because of cost, compared with one in 15 Caucasians. Researchers attributed the gap to lower incomes, lack of supplemental insurance and a greater prevalence of certain chronic conditions.

Meanwhile, a new Health and Human Services analysis of the House- and Senate-passed Medicare legislation concluded that most seniors without drug coverage would see a 50% cut in their prescription drug costs if the benefit is enacted. Seniors with drug costs under $800 a month would save between 43% and 76% on their purchases, HHS said.

States pass a flurry of tort reform legislation

This year has been the most successful for enactment of state civil justice reform legislation since 1995, according to the American Tort Reform Assn. With nearly five months to go, state legislators already have enacted 20 such pieces of legislation. That's one more than the number adopted in all of 1995.

Physicians' demands to change the system have played a key role. "The changing political landscape in the states, the growing consumer awareness of how our civil justice system hurts the economy and the ongoing medical liability crisis all have driven many states to enact meaningful reform this year," said ATRA President Sherman Joyce.

Doctors have been successful in eight states this year, with Texas adopting some of the strongest medical liability reforms. The bill caps noneconomic damages at $250,000. West Virginia, Arkansas and Georgia are among other states that adopted reforms. And the numbers could rise higher before the year is over. At press time, the Florida Legislature was scheduled to return to Tallahassee for its third special session of the summer to address tort reform.