Medicare managed care plans will receive an increase of
just over 6.5% on average in per capita payments when the
rates for 2005 are announced in May, according to a
preliminary estimate from the CMS. Those new ratesfor which
half of the payment will be based on the health status of the
enrollee, a factor that accounts for only 30% of the payment
this yearare expected to lead plans to lower premiums for
members and to enrich the benefit packages they offer. . .
CMS announced on April 1 rules for drug company reporting
on the average sales prices of drugs administered to Medicare
beneficiaries in physicians' offices. The first of the
reports, required under last year's Medicare act, was due
April 30, with additional data to be furnished every 90 days.
CMS says that companies, when calculating the average sales
prices of the drugs, must include volume discounts, prompt pay
discounts, cash discounts, chargebacks, and rebates. For any
piece of information not available by the quarterly deadline,
manufacturers are to take the totals for the most recent 12
months for which they have the figures and divide them by 4. .
Illinois Gov Rod Blagojevich persuaded Walgreens to join a
state program intended to help seniors afford prescription
drugs. By adding its 457 Illinois stores to the program,
Walgreens upped the total participating outlets by more than
25%. Although the program is set up to allow pharmacies to
pick any of 4 levels of discounts, most have chosen the lowest
level (12% off brand-name drug prices and 35% off generic drug
prices) or, like Walgreens, the deepest discounts (15% off
brand-name drug prices and 50% off generic drug prices). . .
Drug Benefit Trends 16(5):236-239, 2004.
2004 Cliggott Publishing, Division of CMP Healthcare
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