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Volume 13 Number 62 News: Part D Drug Benefit The Medicare program announced March 31 a final rule that is designed to prevent low-income beneficiaries from being reassigned to a different Part D drug plan. In a statement, the Centers for Medicare & Medicaid Services said its final rule could allow nearly 1 million Medicare beneficiaries with limited income and resources to remain in their Medicare prescription drug plan, without having to pay a premium. The rule, set for April 3 Federal Register publication, is to take effect May 31. The agency said that, if the rule had been in place for the 2008 plan year, the number of reassignments would have been reduced by 850,000. The new rule applies to people with Medicare who are eligible for Medicare's low-income subsidy or LIS provided under the Part D prescription drug program, CMS explained. CMS said that, under current policy, LIS beneficiaries who are enrolled in prescription drug plans that no longer offer a zero-premium plan, and who have not chosen a different plan, are reassigned by Medicare to a different prescription drug plan in their region that offers zero-premium coverage. A proposed rule was issued in January, with comments due March 3 (No. 3 HCDR 1/7/08) a0b5q0g1b1). Calculation of Benchmarks CMS said its final rule changes the way that Medicare will calculate the regional low-income subsidy benchmarks, based on comments received on the proposed rule issued in January. CMS said the LIS benchmarks reflect the amount of a plan's premium that will be paid by the federal government through the low-income subsidy. For example, CMS said, the federal government pays up to 100 percent of the Part D premium for LIS beneficiaries who are in plans with premiums below the regional LIS benchmark. A reduced low-income subsidy benchmark means that there are fewer plans that offer low or zero premiums for beneficiaries, CMS said in its statement. "That results in more beneficiaries being reassigned to other plans," the agency said. With the final rule, the benchmarks will be weighted based on each plan's share of enrollees receiving the low-income subsidy, rather than their share of total Part D drug benefit enrollment, the Medicare agency said. The result of this, CMS said, is that fewer LIS beneficiaries will have their drug coverage disrupted by having to change prescription drug plans in order to avoid paying a premium. The final rule is expected to be posted online. The proposed rule from January.
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