prescription drug benefit

HHS: Medicare pharmacy pay lower than Medicaid

Mon, 14 Jan 2008 06:59:55 -0500

A new report from the HHS Office of Inspector General has given pharmacies ammunition in their fight for better reimbursement under the Medicare prescription drug benefit. According to the report, which was requested by 33 senators in response to pharmacy industry complaints, pharmacies charge health insurers an 18 percent surcharge on the cost of medications, and get a dispensing fee of about $2.27 per prescription under the Medicare drug benefit system. That's about $2 less than what they get in dispensing fees for Medicaid prescriptions, the OIG report concluded. The Association of Community Pharmacists says that this level of reimbursement is inadequate, as it doesn't cover all of its members' costs. The ACP says that pharmacies would have to charge a premium of more like 20 percent to 21 percent to stay in business.

At this stage, it's not clear what will happen next, as the report doesn't make any specific recommendations. But it seems likely that the senators will seek to gather more information, perhaps at a future hearing.

To learn more about this issue:
- read this Kaiser Daily Health Policy Report item

Related Articles:
Medicare Part D, healthcare play out in an election year. Report
'Mixed successes' of Medicare Part D. Report

Stark files universal coverage measure

Sun, 01 Apr 2007 20:01:36 -0400

Rep. Pete Stark (D-CA), already a high-profile figure in the industry thanks to the self-referral rules bearing his name, has taken a stance on the universal health coverage issue. Stark, who serves as chairman of the House Ways and Means Health Subcommittee, has introduced a bill creating a universal health plan. Under the AmeriCare Health Care Act, all U.S. citizens would be covered either through their employer or Medicare-like government insurance. To extend this coverage, AmeriCare would use Medicare's administrative functions, but would add a a prescription drug benefit, mental health parity, pediatric care, family planning and pregnancy services. The measure would limit out-of-pocket costs, and subsidize costs for people with incomes of less than 300 percent of the federal poverty level. The AmeriCare program would cost $154.5 billion, but would save households, states and local governments more than that, resulting in a net $60.7 billion reduction in overall spending, according to estimates by the Commonwealth Fund.

To learn more about Stark's proposal:
- read this United Press International piece
- read Rep. Stark's press release on the subject

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Edwards proposes $120B universal health plan. Report
Universal health model emerges. Analysis
Universal healthcare rising in '07. Report

GAO says U.S. can't afford more healthcare

Tue, 06 Mar 2007 19:01:37 -0500

While it's all well and good to expand health coverage to more uninsured Americans, doing so would impose an untenable burden on the federal budget, according to a top government official. Government Accountability Office head David Walker says that existing federal government commitments such as Social Security and Medicare are already breaking the federal bank. While some have suggested that economic growth--and a corresponding rise in tax revenues--can solve the problem, Walker says that it just can't happen.

GAO research concluded that federal liabilities have climbed 150 percent over the last six years alone, hitting $50 trillion in 2006. The Medicare Part D prescription drug benefit alone accounts for about $8 trillion of these expenses. Proposals for expanding federal health coverage--which, for example, grow the Medicaid program--can't work, he suggested. Instead, the U.S. government may have to impose austerity measures such as limiting eligibility for Medicaid by raising the income level at which people qualify.

To get more of Walker's comments:
- read this article from The Atlanta Journal-Constitution

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Release: Familymeds Announces Worksite Pharmacy

Maureen Martino — Thu, 09 Nov 2006 11:14:14 -0500

Familymeds Announces Worksite Pharmacy(SM) Contract with Toyota

Familymeds to Operate an On-Site Pharmacy at Toyota's New Truck Plant in San Antonio, Texas

FARMINGTON, Conn., Nov. 9 /PRNewswire-FirstCall/ -- Familymeds Group, Inc. (Nasdaq: FMRX), a specialty pharmacy and medical specialty product provider, today announced that it has signed a contract with Toyota (NYSE: TM) to operate a Worksite Pharmacy(SM) at Toyota's new truck plant in San Antonio, Texas. Familymeds' on-site pharmacy will open January 2, 2007 to exclusively service Toyota team members, participating on-site suppliers and their dependants.

Ed Mercadante, R.Ph., Chairman and Chief Executive Officer of Familymeds, stated, "We are extremely pleased and excited to work with Toyota and to be a part of its new, world-class facility in San Antonio. Toyota's corporate culture emphasizes employee health and wellness, and innovative approaches to benefits are a priority throughout the international organization. This new partnership, coupled with the ongoing success of our Worksite Pharmacy initiative, underscores our commitment to value for major employers like Toyota as well as Familymeds and our shareholders."

Familymeds operates and locates Worksite Pharmacies for large employers seeking to control overall healthcare costs and employee prescription drug benefit expenditures while maintaining high employee satisfaction through improved accessibility and convenience. Familymeds' Worksite Pharmacies are full service pharmacies that operate at an employer's work site and serve only the host company's employees, retirees, and their dependents.

Under the contract with Toyota, Familymeds will operate a full service pharmacy at the site of Toyota's newly constructed plant in San Antonio. The plant, which is scheduled to begin operations next week, will employ approximately 2,000 Toyota personnel.

"We are thrilled to contract with a leading company like Toyota for our third Worksite Pharmacy," said Rees Pinney, Senior Vice President of Employer Sponsored Pharmacy for Familymeds. "We view this as a major milestone achievement that exemplifies our targeted strategy for growth. We believe our proven model will provide significant savings for Toyota while offering an enhanced healthcare experience for team members at the new Texas facility."

The Toyota Worksite Pharmacy in San Antonio will offer prescription medications, home medical equipment and supplies, and a selection of over-the- counter medications, vitamins and nutritional supplements. The pharmacy will be located adjacent to other health care providers, including primary care and fitness, in the Toyota Family Health Center.

Familymeds currently operates a Worksite Pharmacy in the employee center of the Mohegan Sun Casino in Uncasville, Connecticut and at The Scotts Company LLC headquarters in Marysville, Ohio. Combined, these employer sponsored locations have more than 30,000 employees and dependents as potential patients.

About Familymeds Group, Inc.

Familymeds Group, Inc. is a pharmacy and medical specialty product provider formed by the merger on November 12, 2004 of DrugMax, Inc. and Familymeds Group, Inc. Familymeds works closely with doctors, patients, managed care providers, medical centers and employers to improve patient outcomes while delivering low cost and effective healthcare solutions. The Company is focused on building an integrated specialty drug platform through its pharmacy and specialty pharmaceutical operations. Familymeds operates 85 locations, including 7 franchised locations, in 14 states under the Familymeds Pharmacy and Arrow Pharmacy & Nutrition Center brand names. The Company also operates Worksite Pharmacy(SM), which provides solutions for major employer groups, as well as specialty pharmaceutical distribution directly to physicians and other healthcare providers. The Familymeds platform is designed to provide services for the treatment of acute and complex health diseases including chronic medical conditions such as cancer, diabetes and pain management. The Company often serves defined population groups on an exclusive, closed panel basis to maintain costs and improve patient outcomes. Familymeds offers a comprehensive selection of brand name and generic pharmaceuticals, non-prescription healthcare-related products, and diagnostic supplies to its patients, physicians, clinics, long-term care and assisted living centers. More information can be found at http://www.familymedsgroup.com. The Company's online product offering can be found at http://www.familymeds.com.

Safe Harbor Provisions

Certain oral statements made by management from time to time and certain statements contained in press releases and periodic reports issued by Familymeds Group, Inc., including those contained herein, that are not historical facts are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements involve risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Forward-looking statements are statements regarding the intent, belief or current expectations, estimates or projections of the Company, its directors or its officers about the Company and the industry in which it operates, and include among other items, statements regarding its ability to regain compliance with Nasdaq's listing standards and its business and growth strategies. Although Familymeds Group, Inc. believes that its expectations are based on reasonable assumptions, it can give no assurance that the anticipated results will occur. When used in this report, the words "expects," "anticipates," "intends," "plans," "believes," "seeks," "estimates," and similar expressions are generally intended to identify forward-looking statements. Important factors that could cause the actual results to differ materially from those in the forward-looking statements include, among other items, management's ability to successfully implement its business and growth strategies, including its ability to raise additional capital. Familymeds Group, Inc. disclaims any intention or obligation to update or revise forward-looking statements, whether as a result of new information, future events or otherwise.

Contacts

Brandi Piacente, The Piacente Group
212-481-2050; brandi@thepiacentegroup.com

Cindy Berenson, Familymeds Group, Inc.
860.676.1222 x138; berenson@familymeds.com

SOURCE Familymeds Group, Inc.

Norwalk named acting director of CMS

Tue, 26 Sep 2006 20:01:38 -0400

Leslie Norwalk has been named acting director of the Centers for Medicare and Medicaid Services. She will be replacing CMS Administrator Mark McClellan, who announced that he was stepping down from his post to join a think tank focused on improving the U.S. healthcare system. "She is a nationally recognized expert on Medicare issues and played a central role in the successful implementation of the prescription drug benefit and other reforms to Medicare and Medicaid," Mike Leavitt, secretary of the Health and Human Services Department, told Forbes. Norwalk, who is currently the deputy administrator, will assume her new role on October 15th.

For more on Norwalk's appointment:
- read this report from Forbes

SPOTLIGHT: HHS Secretary criticized for use of CDC plane

Wed, 14 Jun 2006 20:01:33 -0400

Democrats are criticizing HHS secretary Mike Leavitt for using a private jet belonging to the Centers for Disease Control and Prevention to promote the new Medicare prescription drug benefit. Leavitt visited more than 90 cities to promote Medicare Part D over the last six months. The jet costs about $3,000 an hour to operate, according to critics. Leavitt says the trips involved legitimate public health related business, noting that in most cases he met with officials to discuss pandemic influenza in addition to the new benefit. Article

CMS announces final Part D numbers

Thu, 08 Jun 2006 20:01:36 -0400

Officials say 11.5 million people signed up for the new prescription drug benefit by the May 15 deadline. The typical beneficiary is paying a premium of $23 a month. That's less than originally projected. "I'd just like to stress what good news this is for our seniors and the Medicare program," said HHS Secretary Mike Leavitt. "Competition works." Critics continue to point out that many of those who have not signed up fall into low-income categories.

- read this article from the St. Petersberg Times

PLUS: The first cases of recipients hitting Part D's "donut hole"--the gap in coverage before the government's catastrophic coverage kicks in--are making news. Meanwhile, in a cleverly timed play designed to exploit the situation, Dunkin Donuts said it is expanding nationwide. Coincidence? We think not. Article

Legislators propose Part D extension

Tue, 16 May 2006 20:01:35 -0400

A powerful bipartisan group of legislators in Washington has introduced legislation that would waive penalties for late sign ups for Medicare Part D. Senator Charles Grassley (R-IA) and Max Baucus (D-MT) introduced a bill which would waive the current penalty. Grassley predicts that the legislation will pass by a unanimous vote in the Senate. Observers are divided over how well the legislation would do in the House, should it move forward. The White House showed signs that it may be willing to compromise. White House spokesman Tony Snow said the administration "will take a close look" at the bill.

- read this New York Times article

PLUS: Medicare officials said 38 million people are signed up for the prescription drug benefit as of Monday. (WSJ sub. req.) Article

Seniors in Part D'mostly happy'

Tue, 25 Apr 2006 20:01:35 -0400

The Kaiser Family Foundation released details of a tracking poll that found that most seniors enrolled in Medicare drug plans are satisfied with their coverage. Eight out of 10 reported no difficulties having prescriptions filled. A companion report "Voices of Beneficiaries: Early Experiences with the Medicare Drug Benefit" provides personal perspectives on the benefit. The new prescription drug benefit continues to receive extensive media coverage, as the May 15 enrollment deadline approaches.

- see the report summary from The Kaiser Family Foundation

SPOTLIGHT: Wide discrepancy found in Part D prices

Thu, 06 Apr 2006 20:01:33 -0400

Federal officials have argued that one of the main benefits of the new prescription drug benefit is that it gives participants a wide selection of possible plans and options to select from. A new study by the California-based Coalition to Advance Prescription Drug Education (CARxE) and the Center for Practical Health Reform finds that seniors participating in the program can save substantial sums if they shop around. According to researchers, prices for most drugs vary by up to 200 percent. Release