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December 18, 2003 | Daily News

Two of the House authors of the newly enacted Medicare prescription drug benefit are seeking to refute criticism that the legislation does not allow insurers to cover gaps in coverage, but a manager's statement accompanying the legislation acknowledges the financing structure provides a disincentive for drug plans to close the coverage gap.

December 18, 2003 | Daily News

Boston Mayor Thomas Menino (D) is threatening to go ahead with a program to reimport drugs from Canada for city employees if FDA does not come up with a plan to allow for reimportation within six months. On Thursday (Dec. 18) Menino urged FDA officials to set up an advisory board to advise the HHS secretary on reimportation issues. Menino plans to follow up with the agency within 60 days.

Menino says the advisory board could help the HHS secretary with the study on reimportation required under the Medicare law.

December 18, 2003 | Daily News

The Congressional Budget Office (CBO) has downgraded its projections of the ability of future Medicare prescription drug plans to contain drug costs because of provisions in the newly enacted law outlining beneficiary rights to appeal formularies, requiring drug plan and manufacturer disclosure of drug price concessions and reducing the risk borne by drug plans.

December 18, 2003 | Daily News

Former CMS Administrator Tom Scully has taken on two jobs since leaving the agency this week, starting work as a policy advisor for the law firm of Alston & Bird in Washington, DC, and in the new field of equity investment for Welsh, Carson, Anderson and Stowe in New York.

Scully's move to the business side of the health care field with Welsh Carson, a specialist in acquisition of health care companies, is a new venture, but he hedged his bets by splitting his time with Alston & Bird, where his value as a policy advisor was assured, he told Inside CMS.

December 16, 2003 | Daily News

Still struggling with a negative fiscal outlook, states are worried Medicare's new drug benefit could diminish their pharmaceutical purchasing power under Medicaid -- one of the states' major tools in their battle to lower prescription drug prices.

December 15, 2003 | Daily News

Technical corrections to the mammoth Medicare bill President Bush recently signed into law are unlikely to take place next year, according to GOP congressional aides.

Many industry sources and observers are widely speculating that a technical amendment package will be pursued next year, but GOP aides are downplaying the possibility. "We think there's got to be a year cooling off period at least," one Republican source aide, adding that it is premature to talk of a technical corrections bill so soon after the legislation was passed.

December 15, 2003 | Daily News

The decision by Medicare conferees not to subsidize certain state pharmaceutical assistance programs for delivering the Medicare drug benefit means state governments will likely have to push seniors to sign up for a confusing new Medicare drug plan even if they are enrolled in state programs that provide superior benefits.

The recently passed bill will allow state programs to "wrap-around" the gaps in the Medicare drug benefit, amounting to significant savings for the costly state programs -- assuming that seniors will switch over to it.

December 11, 2003 | Daily News

Sen. Orrin Hatch (R-UT) is criticizing the 180-day generic drug exclusivity section of the drug patent reform provisions passed as part of the Medicare drug benefit. Hatch is floating a draft he claims will help fix a new "loophole" created by the new law.

December 11, 2003 | Daily News

After two legal defeats, the Bush administration has rolled out its latest discount card plan to immediately lower Medicare beneficiaries drug costs -- this time with the legal authority a federal court twice said it lacked.

December 09, 2003 | Daily News

The Medicare bill's generous payment incentives for new regional preferred provider organizations (PPOs) will likely allow them to draw enrollees away from locally based HMOs, putting such pressure on these private plans that they may not be a viable alternative by the time a controversial 2010 demonstration program makes them compete head-to-head with fee-for-service Medicare, according to lawmakers and experts familiar with the industry.

December 08, 2003 | Daily News

The American Association for Homecare (AAHomecare) and allied stakeholders are looking to lobby Congress next year to repeal or at least modify a section of the Medicare reform bill that reduces certain durable medical equipment (DME) payments to Federal Employees Health Benefits Program (FEHBP) levels.

December 08, 2003 | Daily News

The Congressional Budget Office predicts the cost of the Medicare prescription drug benefit signed into law by President Bush Dec. 8 will escalate rapidly after its $400 billion budget is used up in 2013, costing taxpayers more than $ 1 trillion over the subsequent 10 years as more Baby Boomers retire.

That projection is based on maintaining the current rate of increase in prescription drug costs and does not include any improvements in drug coverage, according to Douglas Holtz-Eakin, director of the Congressional Budget Office (CBO).

December 05, 2003 | Daily News

Medicare conferees adopted a strict prohibition against future determinations by CMS that competing drugs are functionally equivalent, choosing language from the Senate bill over the House bill's call for FDA to establish its own standard for when competing drugs have the same impact.

"It's a flat out ban," said a source with the Biotechnology Industry Organization (BIO), which had pushed for the Senate language.

December 04, 2003 | Daily News

Last-minute changes to the Medicare bill added $11 billion to the drug coverage for low-income beneficiaries, but Democratic critics charge the final legislation still falls short of the original Senate bill's low-income protections while sticking states with a permanent bill for Medicare's assumption of the low-income benefit. State lawmakers, who had sought a total buyout, are also upset.

December 03, 2003 | Daily News

Medicare conferees made last-minute concessions to minimize the effect of cuts in drug reimbursement for oncologists and other physicians, even as they extracted another $4.2 billion in savings by including inhalation drugs -- provided by major homecare companies -- in reform of the average wholesale price (AWP) drug payment system. President Bush plans to sign the mammoth Medicare bill Dec. 8.

November 26, 2003 | Daily News

Tucked into the mammoth Medicare deal hammered out by Congress is a provision that would require hospitals not currently covered by the OSH Act to meet the agency's bloodborne pathogen standard by July 1, 2004, or face civil monetary penalties. The new mandate includes state occupational safety and health plans approved under section 18(b) of the OSH Act.

November 26, 2003 | Daily News

Just hours after the Senate passed landmark Medicare reform legislation Nov. 25, Minority Leader Tom Daschle (D-SD) introduced his own bill to strip key provisions from the historic Medicare deal now heading to the president's desk. Daschle's bill aims to make prescription drugs more affordable by allowing the Medicare program to negotiate with industry for lower drug prices and letting Americans reimport U.S.-made drugs.

November 26, 2003 | Daily News

In the face of burgeoning federal deficits, Democrats and senior advocates are going to have a tough time trying to convince Congress to close the coverage gap in the new Medicare drug benefit that now awaits the signature of President Bush, according to lawmakers and experts on both sides of the debate.

November 25, 2003 | Daily News

Five months after the Senate overwhelmingly passed its own Medicare prescription drug bill, a compromise negotiated with House GOP leaders passed the Senate today (Nov. 25) by a much narrower margin as Democratic leaders railed against the inadequacy of the drug benefit and the bill's push for seniors to join private plans.

After Republican leadership was able to narrowly overcome House passed the conference report 220-215 after GOP leaders convinced colleagues to change their votes.

November 24, 2003 | Daily News

Senate Democrats failed in a last-ditch effort to kill the Medicare prescription drug bill today (Nov. 24), as the bill's backers were able to muster just enough votes to defeat, by a 61-39 margin, a budget point of order offered by Senate Minority Leader Tom Daschle (D-SD).

The vote likely indicates the bill will pass the Senate when it comes to a final vote.. It waives all budget points of order against the Medicare bill, clearing the way of additional procedural hurdles Democrats could have put in the way of passage.