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September 07, 2004
New Medicare Rules May Affect You
Read more... Government & Schizophrenia
New Medicare drug-benefit rules in the USA may impact You - The Government is Seeking Public Feedback.
The Medicare Modernization Act, enacted last year and taking effect in
One big issue for the mental health field is the way the benefit will treat people who quality for both Medicare and Medicaid. Called "dual eligibles," these beneficiaries are thought to number about 6.4 million. Up to 40 percent are estimated to have a serious mental illness such as bipolar disorder or schizophrenia. Currently, only Medicaid carries a prescription drug benefit for them.
Dually eligible beneficiaries will see their drug coverage shift from Medicaid to Medicare over time.
The National Alliance for the Mentally Ill (NAMI), worries that dually eligible beneficiaries could find their drug access more limited than it is now. This could happen if the formularies allowed under Medicare are more restrictive than the drug coverage that beneficiaries could obtain through Medicaid, or if the Medicare formularies fail to include a drug that has been covered through Medicaid.
"NAMI would like to see a continuity-of-care requirement" that would
"At the very least, the regulations must ... 'grandfather in' this coverage," states a letter from NAMI to CMS Administrator Mark B. McClellan, M.D., Ph.D.
The notice currently does not contain such a requirement. NAMI will work to
Another big issue for the field involves the way that drug formularies will
But the regulations don't require the committees to conduct their business
A highlight in the regulations, Sperling said, is CMS's decision to name the
For more information, see Centers for Medicare & Medicaid
Posted by szadmin at September 7, 2004 02:41 AM
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