tci Medicare Compliance & Reimbursement - 2005 Issue 29

MEDICARE PART D: Drug Benefit May Harm More Than Help

'Clawback' payments could give states incentives to drop dual eligibles.Many low-income individuals who are eligible for both Medicaid and Medicare could find themselves without prescription drug coverage on Jan. 1, 2006. Because the Medicare Modernization Act demands that states pay the federal government for taking on their Medicaid beneficiaries' prescription drug coverage under the new Medicare drug benefit, many Medicaid benes could fall into a dangerous coverage gap.The best-case scenario for these Medicaid benes is that they will face higher copayments under Medicare and coverage for fewer prescription drugs, according to a Families USA report entitled...

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