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Medicare Part D Plan Formularies Vary Greatly for Dually-Eligible Nursing Home Residents in 2008 |
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LTCPA has released a study comparing formulary coverage of a list of drugs commonly used by nursing home residents among Medicare Part D Prescription Drug Plans (PDPs) available for auto-assignment of dually-eligible beneficiaries in each Medicare PDP region. This review highlights the significant variability in access to specific drugs between these plans. In addition, the survey highlights the increased utilization management techniques implemented by the plans. |
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Read Report (PDF) |
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Washington Legal Foundation Backgrounder: CMS Marketing Guidelines Create 1st Amendment Problems |
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Professor Ronald Rotunda of George Mason University has authored a legal backgrounder, “CMS Information Policy Under Medicare ‘Part D’ Creates First Amendment Problems.” The backgrounder examines CMS’ prohibition on nursing homes and pharmacists providing information to Medicare Part D beneficiaries about Part D plans. Prof. Rotunda finds the CMS restrictions not only violate free market principles, but “are unconstitutional violations of the providers’ First Amendment commercial free speech guarantees.” |
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Read the Backgrounder (PDF) |
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Study Warns Mentally Ill Nursing Home Residents Face Risks If They Don't Get Help Choosing The Right Part D Plan |
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A study warns mentally ill nursing home residents face health risks if they do no receive the most suitable medication. However, many are not able to choose a PDP that covers their drugs without some assistance. |
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Read Study (PDF) |
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Kaiser Study Captures Variations Across Medicare Drug Plans, Highlighting the Need for Beneficiaries to Choose Carefully |
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Medicare’s new private stand-alone drug plans vary significantly – in terms of covered drugs, out-of-pocket costs for specific medications, and restrictions placed on the use of certain drugs - according to an analysis released by the Kaiser Family Foundation. |
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Read the Kaiser Study (PDF) |
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Studies of long-term care pharmacy dispensing costs: |
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Pharmacies that serve institutional sites of care, such as nursing homes, have higher costs of doing business than other pharmacies. To quantify this phenomenon, the Long Term Care Pharmacy Alliance - an organization representing the major national operators of long-term care pharmacies - commissioned the accounting firm of BDO Seidman to conduct a survey of its members' dispensing costs, consolidate the financial information, and issue a report on the costs of dispensing pharmaceuticals to residents in nursing homes and other long-term care sites. |
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Read Executive Summary |
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Pennsylvania General Assembly study |
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Study results (PDF) |
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Controlling Prescription Drug Spending: Cutting Pharmacy Reimbursement is Not the Answer |
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Pharmacies do not control the prices set by drug manufacturers and wholesalers, nor do pharmacies have much control over the prescriptions written by physicians, so cutting reimbursement to pharmacies will have little impact on total prescription drug spending. It's akin to a physician treating a symptom without addressing the underlying condition. |
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Learn more |
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Seniors In Nursing Homes Need Access To A Specialized Medicare Drug Benefit |
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The average resident of a skilled nursing facility is more than 83 years old and needs from six to ten different drugs at any one time – and sometimes more. These residents are frail, unable to care for themselves and need specialized pharmacy services unavailable through the typical retail or mail-order drugstore. |
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Learn more |
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Return and Reuse of Nursing Home Drugs |
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Some states require long-term care (LTC) pharmacy providers to accept and process unused nursing home drugs for credit to the state Medicaid agency. The regulations that implement this policy vary from state-to-state and are further limited by Drug Enforcement Agency (DEA) and Food and Drug Administration (FDA) guidelines, as well as state boards of pharmacy regulations. |
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Learn more |
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LTCPA Files Amicus Brief in PhRMA v. Concannon, Opposes Prior Authorization Based Solely on Cost |
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No.01-188Brief.pdf (PDF) |
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OIG Report Finds Many Duals Auto-Enrolled In Part D Plans That Don't Cover All Their Drugs |
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A report issued by the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) finds many duals have been assigned to plans with inadequate drug formularies. |
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Read the OIG Report (PDF) |
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Kaiser Report on the Transition of Duals to Medicare Part D |
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The Kaiser Foundation report examines the transition process for all 50 states of the dual eligibles to Medicare Part D. |
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Read |
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Study Finds More Nursing Home Residents Need Drug Coverage Than Expected |
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A 2006 University of Maryland study of nursing home residents found 20% lack coverage and could benefit from Medicare Part D. |
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