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Prescription Drug Benefit Primer

by Pamela Kumar, RN •

Physicians will be called on to be advocates for their patients and to help them enroll in the plan that is best for them. Larger medical practices may want to have a designated person who becomes an expert on Part D to guiding patients and share information about the various plans. Although there have been a few bumps in the road, many beneficiaries are getting their drugs easily and the program is expected to smooth out over time.

Medicare Drug Benefit- Trial and Failure

Table. Medicare Part D Standard Cost Sharing.

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Table. Medicare Part D Standard Cost Sharing.

The Bush Administration was not the first to attempt to add a drug benefit to Medicare, although it was the only successful one. In 1988, the Medicare Catastrophic Coverage Act (MCCA), including a prescription drug benefit, was enacted, but major provisions, including the outpatient prescription drug benefit, were repealed in 1989. President Clinton’s proposed Health Security Act of 1993 included a Medicare drug benefit, but the bill died in 1994. Then in the late 1990s, President Clinton proposed a new Medicare Part D, without success. Finally, the Medicare Prescription Drug, Improvement, and Modernization Act passed both the House of Representatives and the Senate and was signed into law in 2003.

References

  1. AARP analysis finds medicare drug benefit will save seniors more money than prescription drug reimportation, USA. Medical News Today January 25, 2006. www.medicalnewstoday.com/medicalnews.php?newsid=35718 . Last accessed. February 6, 2006.
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  2. Prescription Drug Coverage-General Information. http://new.cms.hhs.gov/PrescriptionDrugCovGenIn . Last accessed. February 6, 2006.
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  3. Mundell EJ. Poor planning doomed medicare drug plan launch, critics charge. HealthDay News. January 23, 2006. www.healthday.com/view.cfm?id=530477 . Last accessed. February 6, 2006.
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  4. Bach PB, McClellan JB. A prescription for a modern medicare program. N Engl J Med. 2005;353(26):2733-2735.
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©2006 The Triological Society