U.S. releases new rules on Medicare drug benefits

Federal rules were issued Friday to put into effect Medicare's new prescription-drug plan.

Health and Human Health Services Secretary Tommy Thompson called it an important step, saying it will help older Americans who "have struggled to pay for their medicines."

The rules were published in the Federal Register, the public announcement that the rules are now in effect.

Among things the new prescription-drug plan will do is to help pay for drugs in the fee-for-service Medicare program and will help guarantee that employer-provided health and drug coverage will continue.

"Today sets in motion historic developments for the elderly and disabled," Thompson said.

He added, "In less than a year, for the first time, Medicare will offer a prescription drug benefit to help them pay for the prescription drugs their doctors tell them that they need."

The plan will be operational in November.

A Health and Human Service Department press release said, "While the Medicare-approved drug discount card remains active throughout 2005, the regulations issued today begin the shift from providing discounts and temporary assistance alone to providing broad-based drug coverage in 2006."

Health and Human Services added, "The new regulations will provide a prescription drug benefit available to everyone who is in Medicare, regardless of his or her income, how they get their health care now (whether through traditional fee-for-service Medicare or a Medicare Advantage plan) or how they currently get their drug coverage."

Health and Human Services said the new rules ensure the drug benefit will:

Offer comprehensive help for those with limited means--including no premiums or deductibles for more than nine million beneficiaries,

Give beneficiaries a choice of at least two drug plans that will cover a comprehensive set of both brand name and generic drugs.

Give beneficiaries convenient access to pharmacies, generally within just a few miles or less of their home.

Guarantee that Medicare beneficiaries living in nursing facilities will be able to enroll in a drug plan and take advantage of the new benefit. All prescription drug plans will contract with long-term care pharmacies.

Ensure that dual eligible beneficiaries who have both full Medicaid and Medicare benefits are automatically enrolled in a drug plan if they fail to sign up by the middle of December, so they have no gap in coverage with the transition to the Medicare benefit.

jlamb@gvnews.com | 625-5511 x 27