A closer look at the MEDS Act
A closer look at the MEDS Act
The Medicare Drug and Service Coverage Act of 2002 (MEDS Act), also known as the Emerson-Ross bill, represents a high-water mark for prescription drug legislation in Congress, according to the Pharmacy Benefits All Coalition, an alliance of pharmacy providers and other groups.
Here are some of the reasons why the legislation rates so highly with the coalition:
- Freedom to select a pharmacy provider.
Seniors would have freedom to select their pharmacy provider and, working with their health care team, select the drugs that best meet their needs, a feature that is critically important to Medicare beneficiaries.
- Freedom of choice in drugs.
The plan doesn’t limit seniors to drugs that appear on an approved list, such as a drug formulary. It covers the medications that they and their doctors decide are best (with the exception of certain expensive "lifestyle drugs").
- Comprehensive coverage and reasonable cost sharing.
Seniors would pay a 20% copayment for their medications, the same level of cost sharing under Medicare’s outpatient program and less than the 50% required under other major bills. Seniors also would pay a monthly premium, as well as an annual deductible of $250 — half of the $500 deductible other bills would require.
- Emphasis on generic drugs.
Because seniors will pay a flat 20% copayment, less expensive generic drugs will be encouraged. This will allow seniors to reduce their out-of-pocket spending by choosing a lower-priced drug. Medicare also could lower copayments further to provide additional incentives for the use of generics.
- Medication safety and effectiveness.
The bill provides seniors with access to pharmacists’ medication management services to improve the effectiveness of their drug therapy and reduce errors. This will help control health care spending by improving health care outcomes and avoiding costly hospitalizations and medical procedures.
- Private sector administration.
The plan directs Medicare to contract with third-party carriers to provide administrative support for the benefit. To ensure the best deal for taxpayers, the contracts will be awarded on a competitively bid, fixed fee-per-claim basis.
The Pharmacy Benefits All Coalition was formed to advocate that Medicare prescription drug legislation be designed to provide seniors access to the prescription drugs they need, as well as access to the services available from their pharmacy provider of choice. Members of the coalition include the American College of Clinical Pharmacy, American Pharmaceutical Association, American Society of Consultant Pharmacists, American Society of Health-System Pharmacists, Food Marketing Institute, the National Association of Chain Drug Stores, the National Community Pharmacists Association, the National Council of State Pharmaceutical Association Executives, and the National Retail Federation.
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