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MANAGED CARE EXECUTIVE EDITION October 2002. ©MediMedia USA
NEWS AND COMMENTARY
More elderly to lose M+C drug coverage
The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback. About 200,000 beneficiaries now enrolled in Medicare HMOs will have to find new coverage because of health plan withdrawals, according to the Centers for Medicare and Medicaid Services.
The agency says that nine health plans will exit the program, while another 24 will reduce service areas. That's an improvement over last year, when 58 plans serving 536,000 elderly dropped out of the Medicare program.
"We are disappointed to hear about any beneficiaries losing a health plan option, but the results are far better than expected," says CMS Administrator Thomas Scully.
The program will lose fewer enrollees this year than in any of the last four years (407,000 lost coverage in 1999, 327,000 in 2000).
Beneficiaries affected by the changes received a letter on Oct. 2 that detailed coverage options.
Health plans are leaving the program because of low reimbursement rates. At press time, Scully was lobbying Congress to approve legislation that would bolster funds for M+C.
Without such funding, "even more elderly and disabled Americans will continue to lose their existing prescription drugs and other medical services," says Scully.
This appears to be a concern that's sidetracking other issues, such as increasing Medicare reimbursements for providers.
Scully says that drug coverage for the elderly is the "top health priority" and asks legislators "not to go too far" when increasing physician pay in Medicare.
"The administration is going to push very hard to do [provider] givebacks that are justifiable only from a public policy point of view," Scully tells Congress Daily.