January 18, 2006

Medicare Part D Guidance for States

The Centers for Medicare and Medicaid Services (CMS) issued guidance for states that have accepted temporary responsibility for the Medicare Part D drug benefit for individuals enrolled in both Medicaid and Medicare (dual eligibles). Several states are overriding the federal benefit and providing drug coverage at 100% state expense because of problems implementing the new federal benefit. CMS has stressed that the federal government has no legal authority to reimburse states for such expenses but will help them recover costs from insurers.

January 25, 2006

Update on Medicare Part D Reimbursements

The Department of Health and Human Services (HHS) said yesterday that it will reimburse states for Medicare Part D prescription drug costs for dual eligibles that are not otherwise reimbursable by Part D drug plans. Funding will be provided through a waiver that will be administered under Medicare Section 402 Demonstration Program Authority. According to the announcement, the program will reimburse states for the full cost of providing temporary Part D coverage, including: 1) ensuring payment reconciliation with the Part D drug plans; 2) Medicare payment for any gap between what a plan reimburses and actual expenses states incurred in Medicaid; and 3) some funding for state administrative costs. The waiver will be retroactive to the first day each state began making payments under Part D and has an expected end date of February 15, 2006. However, the HHS secretary will be able to extend the program if necessary.

Summary of Medicaid, Medicare and Health Provisions in the Deficit Reduction Act of 2005

The National Conference of State Legislatures released a summary of Medicaid, Medicare and health provisions in the Deficit Reduction Act of 2005 (S. 1932). To view the summary click here.

January 30, 2006

Congress Returns

The Senate convened today and is scheduled to debate a motion to proceed to conference on the tax reconciliation package. The House returns tomorrow and is expected to take a final vote on the conference report to the budget reconciliation bill. The Congressional Budget Office last week released its cost estimate of the package and scored its savings at $38.8 billion over five years.