Archive
Weekly Email: Week of February 27
I. In the News
California Enacts Emergency Law to Repeal MediCal Reimbursement Cuts
II. Helpful Information
Secretary Leavitt Issues Progress Report II on Medicare Drug Benefit
Part D Draft Guidance for 2007 Available for Public Comment
New Fact Sheet Focuses on Drug Coverage and Access Issues
Fact Sheet to Help Homeless Clients
III. HAP Resources
New HAP Web Address for SHIP Questions
IV. Other Resources
Lawyers to be Volunteer Resource for SHIPs
I. In the News
California Enacts Emergency Law to Repeal MediCal Reimbursement Cuts
California was scheduled to cut MediCal reimbursements to doctors and other health care providers by 5 percent. After a lawsuit and legislative action, however, Governor Schwazenegger signed a law on February 17 to repeal the cuts. The California Medical Association reports that California has the lowest physician participation in Medicaid of any state in the nation.
II. Helpful Information
Secretary Leavitt Issues Progress Report II on Medicare Drug Benefit
On February 22, Department of Health & Human Services secretary, Mike Leavitt released a report with the latest Part D enrollment numbers along with an update on progress that CMS has made thus far. The Centers for Medicare & Medicaid Services (CMS) indicates that 25 million Medicare beneficiaries now have Part D prescription drug coverage. Of these, 5.3 million enrolled individually in the past 3 months.
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CMS Postings
Part D Draft Guidance for 2007 Available for Public Comment
CMS has issued draft guidelines for 2007 plan formularies and transition procedures along with a call for public comment. In “CMS Strategy for Affordable Access to Comprehensive Drug Coverage,” the agency outlines steps it plans to take for calendar year 2007 to review prescription drug benefit plan formularies, protocols, and procedures. In “Transition Process Requirements for Part D Sponsors,” CMS details proposed guidelines for Part D plan transition processes for 2007 that include requiring plans to provide a temporary supply fill anytime during the first 90 days of a beneficiary’s enrollment, and to post their transition processes publicly in a manner similar to their posting of formularies. Comments on the guidance are due to CMS on March 6, 2006. CMS also posted draft call letters for plan bids for public comment. Those comments were due at the close of business today.
New Fact Sheet Focuses on Drug Coverage and Access Issues
In a new fact sheet aimed at beneficiaries, What Drugs Do Medicare Drug Plans Cover? CMS addresses common questions about drug coverage and access to drugs in Medicare Part D drug plans. The fact sheet also describes utilization management tools, such as prior authorization and quantity limits, and the steps a beneficiary can take to get an exception or switch to a new plan.
Fact Sheet to Help Homeless Clients
CMS has distributed a new fact sheet to partners that concentrates on how to help homeless clients, as a unique population, with getting prescription drug coverage through Medicare. The fact sheet contains FAQs and answers, lists of free publications, important contacts, and other resources.
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III. HAP Resources
New HAP Web Address for SHIP Questions
Because we are all extremely busy with Medicare Part D, HAP has created a new email address specifically to address SHIP needs in the most efficient and effective manner. We encourage SHIPs and their partners to send all inquiries and requests for technical assistance to: shiphelp@healthassistancepartnership.org. A member of the HAP staff will respond to your inquiry within 2 business days. You are, of course, more than welcome to contact the staff person who responds to your request by phone or email. We look forward to continue receiving many wonderful and challenging questions from all of you.
IV. Other Resources
Lawyers to be Volunteer Resource for SHIPs
The American Bar Association (ABA), through its Commission on Law and Aging, is encouraging lawyers to volunteer with local SHIPs to help beneficiaries with Part D problems, including coverage determinations and appeals. To promote the effort and to prepare the lawyers, the ABA, along with the Center for Medicare Advocacy and HAP, are co-sponsoring a two-hour long web-cast training entitled “Medicare Part D: A Crash Course for Practitioners,” tomorrow, March 2, 2006, at 1:00 p.m. EST. The trainers include HAP’s Hilary Dalin, Vicki Gottlich of the Center for Medicare Advocacy, and Leslie Fried from the ABA’s Commission on Law & Aging. The ABA will waive the $125 registration fee for lawyers who agree to provide pro bono services through a local SHIP. We urge state SHIP directors who want to participate in this program to respond to a brief questionnaire on HAP’s Medicare page.
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