In a last minute move, Congress cancelled a 5.1 percent cut in Medicare (and thus Tricare) payments to providers that was to kick in on Jan. 1, 2007. Conference negotiators agreed on Dec. 7 to keep Medicare payments at the 2006 rates, and both houses passed the issue on Dec. 9 just before Congress adjourned. The measure also contains a provision to pay medical providers an additional 1.5 percent in the second half of 2007 if they report data on the quality of their care using measures specified by the government. The planned 5.1 percent cut was expected to cause a number of providers to stop accepting new Medicare-eligible patients or to opt out of Medicare entirely. The fix for 2007 ignores future statutory requirements to slash Medicare payments by more than 30 percent over the next seven years.
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The Department of Veterans Affairs is helping some veterans get generic prescriptions for half the VA price. Veterans in health care priority categories 4 through 8 normally must make an $8 co-pay for drugs from the VA that might be available at the $4 rate being offered by Wal-Mart Stores Inc., and Target Corp. VA deputy undersecretary William Feeley has told VA providers they can write prescriptions that can be filled at any private-sector pharmacy. They cannot transfer the veterans' prescriptions directly to a private-sector pharmacy, but they can write new prescriptions if they meet state requirements and cancel existing VA prescriptions. For the $4 drugs available at Wal-Mart, visit:
http://i.walmart.com/i/if/hmp/fusion/genericdruglist.pdf.
For the Target drugs go to:
http://sites.target.com/images/pharmacy/pharmacy_4dollar_program_list.pdf.
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By Kevin Freking, ASSOCIATED PRESS
WASHINGTON - Medicare officials are touting the success of the new drug benefit by pointing to defections from another government program.
"It might interest you to know that about a third of those who are on the Veterans Administration plan chose to enroll in a Part D plan," Health and Human Services Secretary Mike Leavitt told reporters recently, referring to the benefit's official name, Medicare Part D.
Problem is, the Veterans Affairs Department says there have been no signs, large or small, of folks leaving.
"I've seen some of those comments about a million veterans leaving VA for Part D. Our data doesn't support that," said Mike Valentino, the VA's pharmacy director.
About 4.3 million got medicine through the VA this year, up from 4.1 million in 2005 and 3.8 million in 2006, he said. So who's right? It's possible both departments are, but that would mean that nearly 2 million veterans are enrolled in both programs.
Jeff Nelligan, a spokesman for the Centers for Medicare and Medicaid Services, said the agency believes nearly 1.8 million veterans with prior VA coverage have enrolled in private plans offered through Medicare or get medicine from a plan administered by a former employer. Those employers get a tax break for providing drug coverage, and the workers are counted in the program's overall enrollment.
About half of the veterans in Medicare plans were automatically enrolled because their incomes made them eligible for both Medicare and Medicaid.
The VA serves veterans with service-connected disabilities as well as those with low incomes. For some veterans, medicine is free. For others, the only cost is an $8 copay. They pay no monthly premium or other costs. The government subsidizes health care for Medicare beneficiaries to a lesser degree.
Under the standard Medicare plan, beneficiaries pay the first $250 in drug costs, then the government pays for 75 percent of a beneficiaries' medicine until total drug costs reach $2,250. At that point, beneficiaries pay for all their medicine until out-of-pocket costs reach $3,600. From that point, the government picks up 95 percent.
The poor get extra help. The very poor make only nominal co-payments of up to $2 for a generic medicine and $5 for a brand-name drug.
The trade association representing drug manufacturers has adopted a similar strategy as the HHS Department when it comes to touting Medicare's program. "As many as 40 percent of Medicare eligible veterans enrolled in the VA drug plan have opted for a Medicare plan," said Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, in a recent letter to the editor of the Chicago Sun-Times.
With Democrats focusing on letting the government negotiate drug prices, people are taking note of the advantages and disadvantages of the VA's drug coverage. Under the VA's program, drug makers negotiate with the government on the price of medicine. If they don't, the manufacturers can't participate in programs such as Medicaid. The Democrats' fight for government negotiations on drug prices is focused on the lower prices the VA pays for its medicine when compared with what private insurers pay. But there are other important aspects of the VA's health care program that often go unmentioned in the calls for government negotiations.
For example, veterans who get VA health care don't see the family doctor when they get sick or undergo an exam. Nor do they drive down to the local drugstore when they need medicine. The veterans with VA coverage see the doctors who work at the VA's clinics and hospitals. A treatment plan is developed for them. If that plan includes medication, those drugs must be picked up at a VA pharmacy or through home delivery, Valentino said. There are also differences in the list of drugs the VA covers compared with the list of drugs a typical Medicare plan covers. Leavitt described the VA's list, or formulary, as "among the most restrictive in the marketplace." In Medicare, slightly more than half of enrollees are in plans that cover 1,000 to 1,500 medications. Another 35 percent are in plans that cover more than 1,500 drugs, Nelligan said.
Meanwhile, the Veteran's Administration plan covers about 1,300 drugs, Valentino said. But, he calls the number of drugs on a formulary "almost irrelevant." He said if a plan covers the top 200 selling drugs, then it's basically covering everyone's needs. When asked if the VA covers the top drugs used by seniors, Valentino said he was confident that it does. "They are either on our formulary or we have an equally safe and effective drug in that class on our formulary," he said.
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The Houston Chronicle, TX, USA
Shame on the government for fighting currency reforms to aid visually impaired consumers. When it comes right down to it, there is no way to sugarcoat the Bush administration's objection to revamping the nation's paper currency to make it distinguishable to the visually impaired. It's contrary to federal law banning discrimination against the disabled in government programs. And it's downright mean.
The administration, through the Justice Department, appealed a ruling by U.S. District Judge James Robertson, which requires the Treasury Department to develop paper money with features that would allow blind people to tell the difference between denominations. Robertson's order had been prompted by a lawsuit brought by the American Council for the Blind, which asked that bills be made in different sizes or that textured features be added to aid in differentiating bills.
Such changes would not be ground-breaking. Of 180 countries that use paper money, only the United States prints bills that are uniform in size, color and feel in every denomination.
Justice Department lawyers countered that blind people simply should use portable money reading devices to make purchases, or they should use credit cards. But the government has no plans to provide these machines, which cost around $350. Nor does it have a plan to deal with people who are not eligible for credit cards, including children and some of the large percentage of visually impaired Americans who are unemployed because of their disability.
Sight-impaired adults, like the rest of us, value their ability to live as independently as possible. According to their advocates, when it comes to distinguishing between denominations of currency, the blind use folding systems that help them distinguish, say, a $10 bill from a $20. But that only assists a person in knowing which bill to hand a clerk. A person who cannot see still has to rely on the honesty of the sales clerk to return the correct change.
This is not as it should be. Yes, it will cost money to redesign the nation's currency, but the Treasury Department has been in the process of adding new, anti-counterfeit features to paper money for years. Officials should have taken the opportunity to deal with the issue of fairness to blind consumers during that process. It's late, but it's not too late to make this long-overdue change for the better.
http://www.chron.com/disp/story.mpl/editorial/4408471.html
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Secretary of Veterans Affairs R. James Nicholson notified Congress Dec. 19 that he was transferring $250 million from construction and maintenance in order to pay for medical care costs for veterans. His letter suggested that, if Congress doesn't provide more money, Nicholson might have to shift additional funds. In the short term, the initial shift will be reflected in delays in facility maintenance, but if VA funding remains flat-lined beyond mid-February, the department might have to place a freeze on hiring. This would prevent scheduled hiring of additional claims workers to reduce the buildup of pending claims. The administration had requested a $2.8 billion increase for health care in 2007, to be used for mental health and long-term care programs as well as medical care for veterans of the Iraq and Afghanistan wars.
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The Department of Veterans Affairs is notifying wartime veterans and surviving spouses of deceased wartime veterans about an under-used, special monthly pension benefit called Aid and Attendance. The Aid and Attendance pension may be available to veterans and surviving spouses who have in-home care or who live in nursing-homes or assisted-living facilities. Many elderly veterans and surviving spouses whose incomes are above the congressionally mandated legal limit for a VA pension may still be eligible for Aid and Attendance if they have large medical expenses, which can include nursing home expenses, for which they do not receive reimbursement.
To qualify, claimants must be incapable of self support and in need of regular personal assistance.
For more information, call 1-800-827-1000, or visit
www.va.gov
or any local veterans service organization.
Applications may be submitted on-line at
www.vabenefits.vba.va.gov/vonapp/main.asp.
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