Wednesday, October 28, 2009

House Bill likely to be released Thursday -- Will it try to fill the donut hole?

Breaking news from Washington insiders:
House bill language is expected to be released Thursday morning.

There will be a number of key issues to watch for in the House bill and one that impacts patient access is the Medicare Part D Donut Hole. Democratic House leaders have been focused in trying to accelerate the "closing" of the Medicare Part D Donut Hole which leaves seniors with significant out of pocket expense until they reach the catastrophic benefit. One plan would begin to reduce the Part D copayments (or donut hole) as early as January and phase out the coverage gap in 10 years.

The bill that cleared Energy and Commerce would have phased out the donut hole over 15 years beginning in 2011. The underlying bill also shaves $500 from the cost of drugs provided in the coverage gap.


AARP estimates that about 26 percent of Part D beneficiaries who fill one or more prescriptions and receive no other assistance fall into the donut hole and spend four months in the coverage gap on average.

Few issues are as important to patient access for oral and self-administered drugs as the Medicare Part D Donut hole issue so this will be a key issue senior may rally around.

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