Navigation Links
Medicare Drug Plans Are Onerous and Restrictive

Doctors and pharmacists face a lot of problem due to the new Medicare drug plan. Each plan has its own list of covered drugs, known as a formulary. // These plans require the patients to obtain prior authorization from the doctors. One plan may have 25 or 30 forms for prior authorization for different drugs. Most states have at least 40 Medicare drug plans.

Doctors say that these Medicare plans make the system complicated and delay the access of the medication. On the other hand the insurers say the requirements save money and promote the proper use of the medications. Dr. Jeffery A. Kerr said that these plans have created significant hurdles that patients and physicians must jump over before getting their medications. Dr. Kerr said the Medicare plans were more noticeable because Medicare beneficiaries are high users of prescription drugs.

Dr. Steven A. Levenson of Towson, Md., president-elect of the American Medical Directors Association said that the Medicare drug plans with the help of the management prevent the access to medically appropriate drugs, including drugs on the patient’s own formularies. The pharmacists also face a lot of problems as they have to request prior authorizations for hundreds of drugs taken by Medicare patients, which have its own policies, forms and procedures.

President Bush said that these plans benefit a number of senior citizens. He also said that those who enroll in this plan will end up spending only about half of what they used to spend on prescription drugs each year. He said that these problems will soon be cleared.

Francis S. Soistman Jr., executive vice president of Coventry Health Care, said that he was not aware about the number of forms the doctors have to fill in before prior authorization.

His company's Web site has 39 forms for doctors to use when prescribing certain drugs for Coventry Medicare plans, marketed under the name AdvantraRx. At the top of each form is a logo saying AdvantraRx: Medicare prescription drug plans made easy. But then he said that each drug has a unique clinical criterion that must be met. Hence these forms serve as a checklist of necessary information which is needed for the company’s review. He also said that prior authorization limits the use of certain drugs like OxyContin and Accutane. In addition, this would prevent the overuse of high-cost medications and to ensure that equally effective, less expensive agents are used first.

The prior authorization forms requires the doctors to provide details of laboratory test results, all office notes and other data to show why certain drugs are needed.

But Dr. Lyons said that it would be desirable to simplify and standardize the prior authorization process.

Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services said that the program was working smoothly for the vast majority of the beneficiaries and that he would look into all the other problems. He also said that there were improvements on a daily basis.

Officials reported that the health plans have been encouraging and the growth of prescription drug spending slowed to 8.2 % in 2004, after nine years of double-digit increases.

John Feather, executive director of the American Society of Consultant Pharmacists said that the use of prior authorization is far more prevalent in Medicare than in commercial insurance programs. Dr. Charles A. Crecelius, a geriatrician in St. Louis, said that the drug plans say they cover more than 90 of the 100 drugs but did not do so. This is due to the reason that the drug may be on the formulary but difficult to obtain because of the prior authorization and other rules.


'"/>




Related medicine news :

1. House heads for Medicare drug vote
2. Medicare Drug Deadline not to be extended
3. New Medicare Plan - Mixed Reaction among Pharmacists.
4. Medicare Data would help in Drug Validation
5. Medicare Queries Expected To Increase Over Time
6. Medicare to cover services provided by rural health care personnels.
7. Cancer test expenses taken up by Medicare
8. Nurse Practitioners Are Not Recognized By Medicare
9. Medicare Drug Plan Is Not Working in The US
10. Blue Cross Signs Up 110,000 Minnesotans For Part D Medicare Plans
11. Rising Medicare costs
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:2/10/2016)... ... 10, 2016 , ... Intermedix announced on Wednesday that it ... emergency medicine professional association, to support the organization's newly established physician group with ... Emergency Medicine, or AAEM, seeks to empower emergency physicians to control their own ...
(Date:2/10/2016)... ... February 10, 2016 , ... The Wickman Agency ... to assist the local community. Pledging to select a new beneficiary every 60 ... the area. Their goal is to bring community awareness to important local causes ...
(Date:2/10/2016)... ... February 10, 2016 , ... 10 Best Water is excited ... bottled water brand owners that topped the list as a result of their commitment ... The premier brand was Tibet 5100, a top notch water company that specializes in ...
(Date:2/10/2016)... ... 10, 2016 , ... Dr. Jessica Barron, of Barron Family Dental in ... patients and families in the North Metro Denver area. The new dental practice focuses ... dentistry, and all in the most relaxing environment. , While some dental visits can ...
(Date:2/10/2016)... ... February 10, 2016 , ... ... bring together more than 200 of the country’s top healthcare executives to share ... “The true benefit of the Forum is the provider-centric perspective, experience, expertise and ...
Breaking Medicine News(10 mins):
(Date:2/10/2016)... Inc. (Vanda) (NASDAQ: VNDA ), today announced financial ... year ended December 31, 2015. --> ... for Vanda with the continued growth of HETLIOZ in ... for Non-24," said Mihael H. Polymeropoulos, M.D., Vanda,s President ... product portfolio builds on this success and underscores Vanda,s ...
(Date:2/10/2016)... new report from business intelligence provider GBI Research - Alzheimer,s Disease Therapeutics ... than double from just under $5 billion in 2014 to an estimated $10.4 ... Canada , France , Germany ... UK, and Japan , and will primarily be driven by ... , France , Germany , ...
(Date:2/10/2016)...  CVS Health (NYSE: CVS ) is offering ... Santa Clara County, CA , in response to ... University campus. CVS Pharmacy stores and MinuteClinic walk-in medical ... disease. Students at Santa Clara University who have not ... anyone who has had close contact with a person ...
Breaking Medicine Technology: