Medicare Part D Digest

By Susan M. Pettey, J.D., M.P.A., Caring for the Ages

August 2006

For the five months that ended in April 2006, virtually all Medicare Part D plans increased prices for most of the top 20 drugs prescribed, according to a report by Families USA. Here are other related facts to keep you up to date on Medicare Part D developments.

Drug prices on the rise. Price increases for the top 20 drugs averaged 3.7%, with doses of three of the top drugs (Celebrex, Lipitor, and Aricept) rising 6% or more. The study showed the Department of Veterans Affairs (VA) consistently negotiated lower prices than those of Part D drug plans.

No late penalty, for some. CMS has announced an opportunity for some Medicare beneficiaries to enroll in Part D without imposition of the late penalty. Medicare beneficiaries who quality for extra financial assistance for Part D prescription drug coverage, or who live in an area affected by Hurricane Katrina, will be able to enroll without penalty through December 31, 2006.

Plans are told to pay up. Pharmacists are calling for passage of legislation that would require Part D drug plans to offer electronic payments and to make payments within 14 days.

A CMS survey found that pharmacists are typically paid in 30 days or less by Medicare prescription drug plans. CMS found that the top 20 PDPs, which account for 94% of PDP enrollment, have billing cycles of 15 days or less. Pharmacists have taken issue with the CMS survey, saying it reflects only drug plan policies and not actual payments.