tci Medicare Compliance & Reimbursement - 2005 Issue 15

DRUG BENEFIT: Rx Plans May Target Dual Eligibles

Plans, PBMs looking at automatic enrollees first.Uncertainty surrounds many facets of Medicare's prescription drug benefit, as plan-sponsor hopefuls submitted their applications March 23. Little is known of drug-only insurance plans bearing partial risk for enrollees' prescription-drug costs, and drug-cost and utilization information is scarce for Medicare beneficiaries. That leaves would-be sponsors with little information on which to base the bids they must submit by June 6. Speculation On The Rise About Target Groups But as the Centers for Medicare and Medicaid Services (CMS) release more detailed guidelines and potential sponsors announce their intentions, the picture is becoming a...

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