boutons_
03-13-2006, 02:09 PM
March 13, 2006
Pharmacists Say Drug Plan Threatens Their Income
By ROBERT PEAR (http://topics.nytimes.com/top/reference/timestopics/people/p/robert_pear/index.html?inline=nyt-per)
WASHINGTON, March 12 — Pharmacists say they have been losing money under Medicare's new prescription drug benefit, and they have taken their concerns to the White House, forcing the administration to confront political problems caused by the rocky start of the program.
In a meeting last week with Karl Rove (http://topics.nytimes.com/top/reference/timestopics/people/r/karl_rove/index.html?inline=nyt-per), the president's senior adviser, the druggists said many independent pharmacies might have to shut their doors because they were not being paid adequately or promptly under Medicare. In the last two months, they said, pharmacists have given away millions of dollars' worth of medications for which Medicare drug plans should have paid.
The pharmacists who visited the White House were all from Texas. Several have close ties to Mr. Rove and President Bush. But their concerns are shared by retail pharmacists across the country, who said that Medicare drug plans were paying them less than it cost to fill prescriptions for the beneficiaries.
Bill C. Pittman, a former president of the Texas State Board of Pharmacy who is chairman of Pharmacists for Bush, a political fund-raising group, arranged the meeting, held on Monday at the White House.
Richard E. Beck, one of the Texas pharmacists who met with Mr. Rove, said, "Pharmacies are losing money on Medicare." Slow payment by Medicare drug plans has caused cash-flow problems for many pharmacies, he said.
Mr. Pittman said he told Mr. Rove and other officials: "If pharmacists don't receive immediate relief, some will go broke. Others are hurting so bad that they will choose not to participate in Medicare and Medicaid."
Mr. Bush has described the drug benefit as "the greatest advance in health care for seniors since the founding of Medicare" in 1965. Administration officials said beneficiaries were saving large amounts of money because prescription drug plans had negotiated deep discounts with drug makers and pharmacies.
The new benefit is delivered by private health plans subsidized by Medicare. The drug plans have contracts with pharmacies. Medicare officials said they would help pharmacists enforce the terms of these contracts. But pharmacists said this was not enough because insurers typically offered the contracts on a "take it or leave it" basis.
The pharmacists underscored the political significance of their concerns in a report presented to Mr. Rove and Allan B. Hubbard, assistant to the president for economic policy.
"Most independent community pharmacists are small-business Republicans," the report said. "Pharmacists want to be supportive of this administration, and they can play an active role in the midterm elections. But pharmacists need to be able to point to some corrective actions being taken by the administration."
Trent D. Duffy, a White House spokesman, said: "From our perspective, it was a positive, productive meeting. We want to understand the concerns of pharmacists. They play a critical role in delivery of the drug benefit. At the same time, we want to make sure that seniors are getting the best possible deal."
As of mid-February, 342,000 people had enrolled in prescription drug plans in Texas, more than in any other state. An additional 230,000 Texans were in Medicare plans that covered drugs along with hospital care and doctors' services.
Even as pharmacists take on new duties under Medicare, they are discovering that they will be paid less than they now receive under Medicaid, the program sponsored by federal and state governments for low-income people.
In February 2005, Mr. Bush proposed significant cuts in Medicaid payments to pharmacies. Many of those cuts were included in a deficit reduction bill that he signed into law last month. In his 2007 budget, he proposed further cuts.
Critics called the cuts immoral. Mr. Bush replied, "It's not immoral to make sure that prescription drug pharmacists don't overcharge the system." His comment, in Manchester, N.H., on Feb. 8 this year, infuriated many pharmacists because it seemed to suggest that they were cheating the government.
In a letter to the president, James L. Martin, executive director of the Texas Pharmacy Association, said, "It has become obvious that you and your advisers do not understand the profession of pharmacy."
Druggists said they had no discretion in deciding how much to charge patients under Medicare and Medicaid. Those decisions are made by Medicare drug plans and state Medicaid programs, they said.
Mr. Martin, one of the pharmacists who met with Mr. Rove, said Mr. Bush's comment was particularly galling to pharmacists because they had "bailed out the Medicare prescription drug program" in its first weeks.
Pharmacists helped hundreds of thousands of people sort through scores of prescription drug plans. They filled millions of prescriptions even though they could not get the information needed to verify eligibility.
Michael O. Leavitt (http://topics.nytimes.com/top/reference/timestopics/people/l/michael_o_leavitt/index.html?inline=nyt-per), the secretary of health and human services, said pharmacists' efforts had been "nothing short of heroic." In the first month of the Medicare drug program, he said, many pharmacists provided "three-to-five-day supplies of medicines to beneficiaries without payment."
In an e-mail message to Mr. Rove on Feb. 13, Mr. Beck wrote, "I have been a loyal Republican for a long time." But he said pharmacists were "distraught that a Republican president would attack our profession."
Mr. Beck, who is vice president of American Pharmacies, a purchasing co-op based in San Antonio, said the first six weeks of the new Medicare program had been "a total fiasco" for many pharmacists. "I have some members on the brink of going out of business," he said.
In an e-mail response, Mr. Rove said: "The president was not attacking pharmacists and pharmacies. He was responding to the Democrat leader of the Senate who called the Medicaid reforms 'immoral.' "
( .. by saying the problem dubya was attacking was the cheating and overcharging by pharmacists. Rove is a fucking liar. )
Pharmacists said that Medicare drug plans were paying them less than Medicaid and commercial insurers paid for the same services.
In an interview, Mr. Beck said: "Reimbursement by Medicare drug plans is very low and slow. Pharmacists are being asked to bankroll the program. Many have to dig into personal savings and take out loans to stay in business."
Medicaid and commercial insurers pay pharmacies 7 to 15 days after a prescription is filled, but Medicare drug plans often take 30 days or more, Mr. Beck said.
Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said he thought the cash-flow problems had been resolved, but he promised to investigate any complaints.
The pharmacists offered several recommendations to the White House. They said the government should require prompt payment, by electronic transfer, every week or 10 days. They said Medicare should give pharmacists a financial incentive to dispense low-cost generic drugs rather than brand-name medications.
And they said Medicare drug plans should not be allowed to advertise a specific drugstore company on their member identification cards. Such "co-branding arrangements" confuse beneficiaries by suggesting they cannot use other drugstores, the pharmacists said.
"You don't have advertising on a Social Security card," said Marvin D. Shepherd, a professor at the College of Pharmacy at the University of Texas, who attended the White House meeting. "Why would you have advertising on Medicare prescription drug cards?"
( ... because Repug priority is corporate welfare and payback, not running govt efficiently and fairly)
Copyright 2006 (http://www.nytimes.com/ref/membercenter/help/copyright.html)The New York Times Company (http://www.nytco.com/)
Pharmacists Say Drug Plan Threatens Their Income
By ROBERT PEAR (http://topics.nytimes.com/top/reference/timestopics/people/p/robert_pear/index.html?inline=nyt-per)
WASHINGTON, March 12 — Pharmacists say they have been losing money under Medicare's new prescription drug benefit, and they have taken their concerns to the White House, forcing the administration to confront political problems caused by the rocky start of the program.
In a meeting last week with Karl Rove (http://topics.nytimes.com/top/reference/timestopics/people/r/karl_rove/index.html?inline=nyt-per), the president's senior adviser, the druggists said many independent pharmacies might have to shut their doors because they were not being paid adequately or promptly under Medicare. In the last two months, they said, pharmacists have given away millions of dollars' worth of medications for which Medicare drug plans should have paid.
The pharmacists who visited the White House were all from Texas. Several have close ties to Mr. Rove and President Bush. But their concerns are shared by retail pharmacists across the country, who said that Medicare drug plans were paying them less than it cost to fill prescriptions for the beneficiaries.
Bill C. Pittman, a former president of the Texas State Board of Pharmacy who is chairman of Pharmacists for Bush, a political fund-raising group, arranged the meeting, held on Monday at the White House.
Richard E. Beck, one of the Texas pharmacists who met with Mr. Rove, said, "Pharmacies are losing money on Medicare." Slow payment by Medicare drug plans has caused cash-flow problems for many pharmacies, he said.
Mr. Pittman said he told Mr. Rove and other officials: "If pharmacists don't receive immediate relief, some will go broke. Others are hurting so bad that they will choose not to participate in Medicare and Medicaid."
Mr. Bush has described the drug benefit as "the greatest advance in health care for seniors since the founding of Medicare" in 1965. Administration officials said beneficiaries were saving large amounts of money because prescription drug plans had negotiated deep discounts with drug makers and pharmacies.
The new benefit is delivered by private health plans subsidized by Medicare. The drug plans have contracts with pharmacies. Medicare officials said they would help pharmacists enforce the terms of these contracts. But pharmacists said this was not enough because insurers typically offered the contracts on a "take it or leave it" basis.
The pharmacists underscored the political significance of their concerns in a report presented to Mr. Rove and Allan B. Hubbard, assistant to the president for economic policy.
"Most independent community pharmacists are small-business Republicans," the report said. "Pharmacists want to be supportive of this administration, and they can play an active role in the midterm elections. But pharmacists need to be able to point to some corrective actions being taken by the administration."
Trent D. Duffy, a White House spokesman, said: "From our perspective, it was a positive, productive meeting. We want to understand the concerns of pharmacists. They play a critical role in delivery of the drug benefit. At the same time, we want to make sure that seniors are getting the best possible deal."
As of mid-February, 342,000 people had enrolled in prescription drug plans in Texas, more than in any other state. An additional 230,000 Texans were in Medicare plans that covered drugs along with hospital care and doctors' services.
Even as pharmacists take on new duties under Medicare, they are discovering that they will be paid less than they now receive under Medicaid, the program sponsored by federal and state governments for low-income people.
In February 2005, Mr. Bush proposed significant cuts in Medicaid payments to pharmacies. Many of those cuts were included in a deficit reduction bill that he signed into law last month. In his 2007 budget, he proposed further cuts.
Critics called the cuts immoral. Mr. Bush replied, "It's not immoral to make sure that prescription drug pharmacists don't overcharge the system." His comment, in Manchester, N.H., on Feb. 8 this year, infuriated many pharmacists because it seemed to suggest that they were cheating the government.
In a letter to the president, James L. Martin, executive director of the Texas Pharmacy Association, said, "It has become obvious that you and your advisers do not understand the profession of pharmacy."
Druggists said they had no discretion in deciding how much to charge patients under Medicare and Medicaid. Those decisions are made by Medicare drug plans and state Medicaid programs, they said.
Mr. Martin, one of the pharmacists who met with Mr. Rove, said Mr. Bush's comment was particularly galling to pharmacists because they had "bailed out the Medicare prescription drug program" in its first weeks.
Pharmacists helped hundreds of thousands of people sort through scores of prescription drug plans. They filled millions of prescriptions even though they could not get the information needed to verify eligibility.
Michael O. Leavitt (http://topics.nytimes.com/top/reference/timestopics/people/l/michael_o_leavitt/index.html?inline=nyt-per), the secretary of health and human services, said pharmacists' efforts had been "nothing short of heroic." In the first month of the Medicare drug program, he said, many pharmacists provided "three-to-five-day supplies of medicines to beneficiaries without payment."
In an e-mail message to Mr. Rove on Feb. 13, Mr. Beck wrote, "I have been a loyal Republican for a long time." But he said pharmacists were "distraught that a Republican president would attack our profession."
Mr. Beck, who is vice president of American Pharmacies, a purchasing co-op based in San Antonio, said the first six weeks of the new Medicare program had been "a total fiasco" for many pharmacists. "I have some members on the brink of going out of business," he said.
In an e-mail response, Mr. Rove said: "The president was not attacking pharmacists and pharmacies. He was responding to the Democrat leader of the Senate who called the Medicaid reforms 'immoral.' "
( .. by saying the problem dubya was attacking was the cheating and overcharging by pharmacists. Rove is a fucking liar. )
Pharmacists said that Medicare drug plans were paying them less than Medicaid and commercial insurers paid for the same services.
In an interview, Mr. Beck said: "Reimbursement by Medicare drug plans is very low and slow. Pharmacists are being asked to bankroll the program. Many have to dig into personal savings and take out loans to stay in business."
Medicaid and commercial insurers pay pharmacies 7 to 15 days after a prescription is filled, but Medicare drug plans often take 30 days or more, Mr. Beck said.
Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said he thought the cash-flow problems had been resolved, but he promised to investigate any complaints.
The pharmacists offered several recommendations to the White House. They said the government should require prompt payment, by electronic transfer, every week or 10 days. They said Medicare should give pharmacists a financial incentive to dispense low-cost generic drugs rather than brand-name medications.
And they said Medicare drug plans should not be allowed to advertise a specific drugstore company on their member identification cards. Such "co-branding arrangements" confuse beneficiaries by suggesting they cannot use other drugstores, the pharmacists said.
"You don't have advertising on a Social Security card," said Marvin D. Shepherd, a professor at the College of Pharmacy at the University of Texas, who attended the White House meeting. "Why would you have advertising on Medicare prescription drug cards?"
( ... because Repug priority is corporate welfare and payback, not running govt efficiently and fairly)
Copyright 2006 (http://www.nytimes.com/ref/membercenter/help/copyright.html)The New York Times Company (http://www.nytco.com/)