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Feds Map Out Medicare Drug, Managed Care Programs

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The Centers for Medicare & Medicaid Services has approved new 2006 Medicare prescription drug program and Medicare managed care program offerings.[@@]

The insurers with products that have been approved can begin selling them starting Oct. 1.

Mike Leavitt, secretary of the Department of Health and Human Services, CMS’ parent agency, says at least 11 organizations will be offering drug plans in each region and that at least one drug plan will cost less than $20 per month in every state but Alaska.

Moreover, there is “no area needing the ‘fallback’ plan that would have been required without at least 2 organizations competing,” CMS officials say in a statement about the new drug plan menu.

Some critics of the program had questioned whether a variety of program requirements would scare private insurers away from the program.

The 9 national prescription drug plan organizations in the market include MemberHealth Inc., Solon, Ohio, and WellCare Health Plans Inc., Tampa, Fla., along with units of Aetna Inc., Hartford; Caremark Rx Inc., Nashville, Tenn.; CIGNA Corp., Philadelphia; Medco Health Solutions Inc., Franklin Lakes, N.J.; PacifiCare Health Systems Inc., Cypress, Calif.; UnitedHealth Group Inc., Minnetonka, Minn.; and WellPoint Inc., Indianapolis.

CMS also has approved many other regional and local prescription drug plan organizations. In some states, such as California, a large carrier such as WellPoint may have several subsidiaries selling Medicare prescription benefits, according to Medicare drug plan database posted on the CMS Web site.

In addition, CMS has approved many insurers’ plans to add new Medicare health maintenance organization and preferred provider organization plans.

America’s Health Insurance Plans, Washington, is emphasizing its members’ efforts to help CMS meet its goal of offering Medicare beneficiaries a wide range of options.

“Seniors and individuals with disabilities nationwide will soon have access to more choices and expanded benefits, AHIP President Karen Ignagni says in a statement.

Ignagni also is welcoming CMS officials’ success at getting the new Medicare drug program and revamped managed care program running by Jan. 1, 2006, in time to meet the implementation deadlines included in the 2002 that created the programs.