Terry Hanushek
04-05-2006, 08:34 AM
The lead story in today's Philadelphia Inquirer reports that Independence Blue Cross, the region's largest insurer has started to make changes to approved drug list or formulary.
Insurer alters Medicare drug list
By John Sullivan
Inquirer Staff Writer
The Philadelphia region's largest insurer says it will make 22 changes to its preferred list of pharmaceuticals for Medicare recipients starting June 1, marking the beginning of a shift that could alter drug plans across the country.
Some experts say such changes, which insurers are planning around the country, underscore a potentially troubling provision of the new Medicare plan: Insurers can add and remove drugs from their approved list every month, while Medicare recipients can change plans only once a year.
Under current law, drug plans can change the drugs as many times as they want throughout the year as long as they give advance notice to their enrollees.
The changes made by insurers would come after a transition period that allowed beneficiaries to get drugs even if their plan did not cover the medicines.
Patients, unhappy with insurers' changes, can appeal to keep getting their old drugs. But they may have trouble navigating the appeals process, said Richard G. Stefanacci, founding executive director of the Health Policy Institute at the University of the Sciences in Philadelphia.
The entire article can be read at:
http://www.philly.com/mld/philly/14264539.htm
The ability for insurers to change their approved drug list has been one of the major concerns of consumer advocates and Plan D oppnents. The fact that these changes are starting even before the 15 May deadline for initial sign ups is even more disconcerting.
Terry
Insurer alters Medicare drug list
By John Sullivan
Inquirer Staff Writer
The Philadelphia region's largest insurer says it will make 22 changes to its preferred list of pharmaceuticals for Medicare recipients starting June 1, marking the beginning of a shift that could alter drug plans across the country.
Some experts say such changes, which insurers are planning around the country, underscore a potentially troubling provision of the new Medicare plan: Insurers can add and remove drugs from their approved list every month, while Medicare recipients can change plans only once a year.
Under current law, drug plans can change the drugs as many times as they want throughout the year as long as they give advance notice to their enrollees.
The changes made by insurers would come after a transition period that allowed beneficiaries to get drugs even if their plan did not cover the medicines.
Patients, unhappy with insurers' changes, can appeal to keep getting their old drugs. But they may have trouble navigating the appeals process, said Richard G. Stefanacci, founding executive director of the Health Policy Institute at the University of the Sciences in Philadelphia.
The entire article can be read at:
http://www.philly.com/mld/philly/14264539.htm
The ability for insurers to change their approved drug list has been one of the major concerns of consumer advocates and Plan D oppnents. The fact that these changes are starting even before the 15 May deadline for initial sign ups is even more disconcerting.
Terry