NY Times: White House Withdraws Plan Allowing Limits to Medicare Coverage for Some Drugs


WASHINGTON — Under pressure from patients, pharmaceutical companies and members of Congress from both parties, the Obama administration on Monday withdrew a proposal that would have allowed insurers to limitMedicare coverage for certain classes of drugs, including those used to treatdepression and schizophrenia.

Medicare officials had said the proposal would have saved money and reduced the overuse of drugs. But it created political problems for the White House, with some Democrats joining Republicans in denouncing the changes, saying they would harm Medicare beneficiaries.

Since the start of Medicare’s prescription drug benefit in 2006, the government has required insurers to cover “all or substantially all” drugs in six treatment areas. The administration proposed in January to lift the requirement for three types of medications: immunosuppressant drugs used in transplant patients; antidepressants; and antipsychotic medicines, used to treat schizophrenia and certain related disorders.


Marilyn B. Tavenner, the Medicare agency administrator, in 2013.CreditJ. Scott Applewhite/Associated Press

In a letter to lawmakers on Monday, Marilyn B. Tavenner, the administrator of the federal Centers for Medicare and Medicaid Services, said officials would not pursue the proposal. “Given the complexities of these issues and stakeholder input, we do not plan to finalize these proposals at this time,” Ms. Tavenner said.

She said the administration had also decided to hold off on three other proposals. One stipulates that insurers can offer no more than two prescription drug plans to Medicare beneficiaries in the same region. Another would give patients greater access to small community pharmacies by requiring insurers to offer contracts to any retail drugstores willing to accept their terms and conditions. A third would allow the government to intervene in negotiations between insurers and pharmacies.

Continue reading here: http://www.nytimes.com/2014/03/11/us/politics/white-house-withdraws-plan-allowing-limits-to-medicare-coverage-for-some-drugs.html?_r=0

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