Easing the Part D burden: A new tool will help

A one-page form makes it easier for physicians to seek exceptions to Medicare drug plans' formulary rules.

Editorial. May 8, 2006.

In health care matters, both clinical and beyond, patients look to their physicians as trusted advisers. Medicare Part D is a case in point.

Beneficiaries have been confused about this new outpatient prescription drug benefit since enrollment began last November. In a February Kaiser Family Foundation survey of seniors, 61% said they understood Part D "not too well" or "not at all."

Many are overwhelmed by the number of drug plan options. Seniors are struggling to figure out how much the different choices cost and whether their medications will be covered. They are dismayed when a drug they need is not in their plan's formulary.

So these patients turn to their doctors for help. The Kaiser survey found that 26% talked to their physician about the new benefit, and 61% said they trust their doctor to help them understand and choose among Medicare drug plans.

As the May 15 deadline for current beneficiaries to enroll in a plan nears, expect questions and serious concern from seniors to continue, if not increase.

Fortunately for doctors, there are resources that can help them assist patients from a clinical standpoint and on Medicare Part D in general.

The latest is a new tool developed by the American Medical Association, along with many working group partners and the trade group America's Health Insurance Plans. It is a one-page form designed to streamline the process by which doctors request prior authorizations and exceptions to plan formularies for particular patients.