tci Medicare Compliance & Reimbursement - 2004 Issue 26

PRESCRIPTION DRUGS: Stand-Alone Rx Plans May Be Doomed, Experts Say

Success of Medicare Part Dis anything but certain. Private prescription drug plans simply won't show up in 2006, and the federal fallback plan is likely the main vehicle through which beneficiaries will get drug-only coverage. That's the feeling expressed by Alliance Capital Senior Vice President Norm Fidel at a recent conference in Washington. Fidel noted that "I still do not find much enthusiasm from [pharmacy benefit managers] or health plans to come out and underwrite" PDPs. The biggest problem: Potential underwriters can't weigh risks because they don't know which beneficiaries -- with what level of health problems and drug...

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