News in brief - Feb. 20, 2006

Medicare drug benefit costs drop - Medicare requires insurers to extend emergency drug supply - Kansas court throws out lawsuit on publicly funded abortions - Arizona doctors drop plans for tort reform ballot initiative for now

Medicare drug benefit costs drop

The estimated 10-year federal price tag for the Medicare drug benefit has fallen from roughly $737 billion to about $679 billion. The drop was largely due to lower-than-expected premium costs from drug plans, combined with seniors choosing less pricey drug coverage options, Centers for Medicare & Medicaid Services Administrator Mark McClellan, MD, PhD, announced earlier this month.

Dr. McClellan cautioned, however, that long-term projections for the program are likely to change again. "The future cost of the ... program remains uncertain because the actual numbers of enrollees, their average cost levels, future developments in new and existing prescription drugs, and other factors are not yet known," he said.

Medicare requires insurers to extend emergency drug supply

The federal government is requiring insurers to cover an additional two months' worth of drugs to beneficiaries who were taking the medications before joining a Medicare drug plan, program officials announced earlier this month.

Federal law already required drug plans to cover a 30-day emergency supply of drugs to seniors and people with disabilities even if the treatment was not covered under the new benefit. An additional 60 days of coverage will give beneficiaries adequate time to find alternative treatments that will be covered, said Dept. of Health and Human Services Secretary Michael Leavitt.

Tens of thousands of Medicare drug plan enrollees, including many who formerly got drug coverage through Medicaid, reported difficulties filling prescriptions in the opening weeks of the benefit. Physicians warned that beneficiaries were in danger of falling off their drug regimens and having sudden declines in health.

Kansas court throws out lawsuit on publicly funded abortions

A Kansas trial court judge on Jan. 25 dismissed a lawsuit filed against Gov. Kathleen Sebelius by Attorney General Phil Kline alleging that abortions paid for with state Medicaid funds violated the state's constitution.

"Clearly it is the role of the legislative branch to attempt to answer major questions of public policy," Shawnee County Judge David Bruns wrote. "It is neither the right nor the duty of the judicial branch to do so."

The court pointed out that the federal government allows use of Medicaid dollars to pay for abortions that are medically necessary to save the mother's life or that result from rape or incest.

"We think it's appropriate the court ruled the way it did. It's a federal program, and they set the rules," said Matt All, chief counsel to Sebelius.

Kline filed the lawsuit in August 2005 directed by a House resolution passed in 2002. Kline said in a statement that he would not appeal the ruling "unless directed to do so by a subsequent resolution by either chamber of the Legislature."

Arizona doctors drop plans for tort reform ballot initiative for now

Arizonans for Access to Health Care, the arm of the Arizona Medical Assn. that focuses on medical liability reform, announced in January that it will not pursue an initiative on the 2006 ballot for a constitutional amendment to cap damages in medical liability cases. Arizona's constitution expressly prohibits limits on economic and noneconomic damage awards.

The AAHC voted unanimously against the move, noting that the number of medical liability claims had decreased nationwide and in the state in the last year. A poll conducted by the group found that Arizona residents had a strong awareness of the issue but were only willing to support reforms that would have little impact.

"The battle is not over, we are just retooling," said Leonard Ditmanson, MD, president of the Arizona Medical Assn. The group will refocus efforts for the 2008 ballot. Until then, Dr. Ditmanson said, the AAHC will support a bill that has received legislative support in the Senate to raise the burden of proof in medical liability cases against emergency doctors from a "preponderance of evidence" to "clear and convincing," which is the current standard for obstetricians.