tci Medicare Compliance & Reimbursement - 2006 Issue 11

PART D: Pharmas Work To Cover 'Doughnut Hole' For Low-Income Benes

Coalition lacks major players--kickback issues could arise.In an attempt to forestall potential problems with the Medicare Part D benefit, several pharmaceutical companies have joined together to develop a plan to provide discounted prescription drugs to Medicare beneficiaries who reach the doughnut hole in their coverage. The coalition could potentially save substantial out-of-pocket costs for those seniors who don't qualify for subsidies. But health plans need to watch out for abuse within the system, experts warn.The so-called "Bridge Rx" program would supply qualifying Medicare benes with discounted drugs, often up to 50 percent reduced cost. This proposal is...

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