CVS Pharmacy Subpoenaed Regarding Discount Drug Program

CVS and the Connecticut Attorney General’s office have sparred on this issue once before. Last session, when CVS officials disagreed with the state’s interpretation of the law the General Assembly passed a bill which clarified the requirement that pharmacies charge CT Medicaid the lowest price offered to consumers. But even now, with little ambiguity left in the law, CVS claims it should not be required to fulfill this obligation because the program was originally developed for uninsured and underinsured individuals, not with Medicaid recipients in mind. Because CVS on its member enrollment forms reserves the right to cancel the voluntary program for any reason, and because it is not required to continue the program by law, the company may indeed terminate the program if Blumenthal continues to push CVS.

CVS has until July 9 to comply with the Attorney General’s subpoena for information on CVS’s threat to cancel the program in Connecticut, which Blumenthal claims is inconsistent with the company’s practices in other states where CVS and other pharmacies have extended their discount drug program to Medicaid beneficiaries. Blumenthal – currently a candidate for Senate to replace retiring Senator Christopher Dodd (D-CT) – hopes his office will be able to force CVS to comply with the law and its practices in other states, as extending this program to Medicaid enrollees would save thousands of pharmaceutical cost dollars, helping to rein in out of control health care costs.

If Blumenthal is unsuccessful, the thousands of uninsured under-65′s and Medicare beneficiaries who rely on the program to stay out of the donut hole coverage gap may find their discount prescription drugs in jeopardy.

Kathleen Sebelius is currently serving as the 44^th Governor of Kansas and the second female governor of Kansas. She was first elected to the Kansas House of Representatives back in 1986 and left the House in 1994 to run for state insurance commissioner. She was elected to the position of Governor in 2002 and was reelected again in 2006. She has been named one of the best governors in America according to Time Magazine in 2005 for eliminating the $1.1 billion debt she had inherited when elected to governor.

Senator Max Baucus of Montana says, “I’m particularly pleased to hear of her selection because she brings such solid experience to the position. Passing comprehensive health-care reform is an absolute imperative this year, and as a former insurance commissioner, Governor Sebelius really gets what needs to be done.”

As the Secretary of Health and Human Services, Sebelius will take charge of an agency with 65,000 employees responsible for the public health, food safety, scientific research, and the administration of the Medicare and Medicaid programs of 90 million Americans.

Medicare Part D Prescription Drug Coverage plan offers coverage for brand name and generic prescriptions drugs to anyone eligible for Medicare and is provided through private insurance plans. In order to be eligible for Medicare Part D, you must be entitled to Medicare benefits under Part A and/or enrolled in Part B. You must also be a resident in the prescription plan’s service area and not be enrolled in more than one Medicare Part D plan at a time. You usually pay a monthly premium and may pay a yearly deductible. Depending on the plan you select, you will also have co-pays or coinsurance for your prescriptions.

Since plans and premiums are changing, experts advise existing Medicare beneficiaries to review their current plans. Lists of covered drugs are changing and so are restrictions and costs so the plan you had for 2008 may not work for 2009. Also, new beneficiaries should look at a variety of plans to see what is best for them and their health needs. Make sure you talk to an expert and learn everything you need to know about the plan you have or are choosing because after Jan. 1, everyone is locked into their plan, with a few exceptions. The few exceptions include people who get low-income subsidies and people who have Medicare HMO or Medicare PPO private health plans.

The premiums of most plans are going up and prescription drugs that were covered last year may not be covered this upcoming year. The Centers for Medicare & Medicaid Services stated that initial deductibles for the standard benefit plan rose from $275 in 2008 to $295 in 2009. Also, beware of the donut hole. This term refers to a “coverage gap.” Within this gap, the beneficiary pays 100% of the cost of prescription drugs before catastrophic coverage kicks in. The initial coverage period covers up to $2,510 worth of prescription drugs. After the initial coverage period ends, the donut hole comes in. The donut hole lasts until you have spent $4,050 out of pocket on co-pays and drug costs. The catastrophic period is when the insurance company pays 95% of additional drug costs once you’re through the donut hole.

There are many people who can help seniors decide what to do when it comes to the Medicare part D Prescription Drug plan. For extra help and more information on Part D, you can visit the Medicare website (www.medicare.gov), call 1-800-MEDICARE, or call your local area agency. There is also a lot of information on the internet to help you in deciding on a plan.