Medicare Rx at a Turning Point: Big Plans Stumble as Part D Enters a Pivotal Year
This article was originally published in RPM Report
United, Humana and especially WellCare are taking their licks in the run-up to the third year of the Medicare prescription drug program. That is just the latest warning sign for pharma and biotech companies that a critical market is entering a critical turning point.
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Pharmacies and wholesalers are expressing their concern about the potential for an upcoming policy change in Part D to disrupt dispensing. Beginning Jan. 1, any medication that does not have an NDC registered with FDA will no longer be covered by the drug benefit.
One of the Obama Administration's first moves in managing the Medicare Part D benefit is to tamp down on the number of beneficiaries who will be randomly assigned to a new plan on Jan. 1. Stability is good for the program politically, but it may also be a sign of more hands-on management by the Medicare agency in the years ahead.
Democrats are threatening to use a budgetary procedure to accelerate the passage of broad health reforms in the next Congress. Republicans are already voicing protest, particularly with the idea of a new government-run insurance plan gaining momentum. But those concerns may fall on deaf ears.