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Articles by Donald E. L. Johnson

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Medicare announces 34 regions for drug benefit administration

CMS announced 34 drug benefit administration plans under which prescription drug benefits will be dispensed under the Medicare Modernization Act of ‘03 (PL 108-173), which begins in January 2006. Impact graphs from the N.Y. Times:

CMS announced 34 drug benefit administration plans under which prescription drug benefits will be dispensed under the Medicare Modernization Act of ‘03 (PL 108-173), which begins in January 2006. Impact graphs from the N.Y. Times:

Some of the drug plan regions are very large. One, covering all of California, has 4.3 million Medicare beneficiaries. Other large single-state regions include Florida, with 3 million beneficiaries, New York (2.8 million) and Texas (2.5 million).

On the other hand, New Mexico, with just 260,000 beneficiaries, is a separate region, as are Mississippi, with 460,000 beneficiaries, Arkansas (470,000) and Oklahoma (540,000).

Maine and New Hampshire, with a total of 420,000 beneficiaries, are one region, while the other four New England states, with 1.8 million Medicare patients, are a separate region.
CMS announced 34 drug benefit administration plans under which prescription drug benefits will be dispensed under the Medicare Modernization Act of ‘03 (PL 108-173), which begins in January 2006. Impact graphs from the N.Y. Times:

Geographically, the largest region consists of seven states in the upper Midwest and northern Plains. The states - Iowa, Minnesota, Montana, Nebraska, North and South Dakota and Wyoming - have 1.9 million Medicare beneficiaries.

The new Medicare law envisions a huge role for private plans. If beneficiaries stay in traditional fee-for-service Medicare, they can get subsidized drug coverage by buying private insurance policies that cover prescription drugs and nothing else. Alternatively, they can join a managed care plan that covers drugs along with doctors’ services and hospital care.

The DHHS announcement is here.

Posted by Donald E. L. Johnson on 12/07/2004 at 11:54 AM

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