GOVERNMENTNews in brief - Dec. 10, 2007Top Medicare drug plans cutting their formularies - Pharmacy associations sue CMS over Medicaid pay - R.I. health system reform meetings begin Top Medicare drug plans cutting their formulariesAll but two of the 10 most popular Medicare prescription drug plans are reducing the number of drugs they will cover in 2008, according to a new analysis by the consulting firm Avalere Health. Taken together, the biggest Part D plans, based on enrollment as a whole, will decrease the size of their drug formularies by 26% next year. The plans covered an average of 3,094 medications this year but will cover an average of only 2,285 medications in 2008. A recent decision by the Centers for Medicare & Medicaid Services to eliminate more than 1,500 formulary drug codes for medications that are no longer approved for use accounts for some of that drop, the report said. "Consumers should look beyond monthly premiums to the specific formularies to ensure drugs that they are concerned about are covered and at a cost level they can afford," said Jon Glaudemans, Avalere Health's senior vice president and the lead researcher on the report. "Changes are occurring at all levels of the Medicare drug benefit -- from significant movements in monthly premiums, to the composition and co-payment structure of formularies." Pharmacy associations sue CMS over Medicaid payTwo pharmacy associations have sued to block the implementation of a Medicaid rule they say will force many pharmacists to charge less than their costs for certain prescription drugs and could force 10,000 or more pharmacies out of business. The National Assn. of Chain Drug Stores and the National Community Pharmacists Assn. filed for an injunction Nov. 7 against the Centers for Medicare & Medicaid Services to block the agency from implementing its "average manufacturers price" regulation, which changes the way pharmacies are reimbursed for dispensing drugs to Medicaid patients. The new rule would classify all types of Medicaid drug dispensers -- such as hospitals, mail order pharmacies and physicians -- as retail pharmacists. This would put independent pharmacists at a disadvantage because they don't have access to the volume discounts other dispensers do, the two organizations say. Said CMS spokesman Jeff Nelligan: "CMS believes that the new AMP regulation ... implements Congress' desire to make Medicaid prescription drug payments more efficient and economical." R.I. health system reform meetings beginRhode Island Lt. Gov. Elizabeth Roberts last month began meetings of Mission: Healthy RI, an advisory group of representatives from the medical community, the insurance industry, hospitals, business owners, labor leaders, consumers and other stakeholders. She plans to introduce a package of health system reform legislation during the 2008 session. Copyright 2007 American Medical Association. All rights reserved. |
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