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Medicare Rx at a Turning Point: Big Plans Stumble as Part D Enters a Pivotal Year

This article was originally published in RPM Report

Executive Summary

United, Humana and especially WellCare are taking their licks in the run-up to the third year of the Medicare prescription drug program. That is just the latest warning sign for pharma and biotech companies that a critical market is entering a critical turning point.

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Unapproved Drugs Become Unpaid Drugs, Effective January 1

Pharmacies and wholesalers are expressing their concern about the potential for an upcoming policy change in Part D to disrupt dispensing. Beginning Jan. 1, any medication that does not have an NDC registered with FDA will no longer be covered by the drug benefit.

Not So Random Selection: Medicare Agency Cuts "Churn" In Part D Enrollment

One of the Obama Administration's first moves in managing the Medicare Part D benefit is to tamp down on the number of beneficiaries who will be randomly assigned to a new plan on Jan. 1. Stability is good for the program politically, but it may also be a sign of more hands-on management by the Medicare agency in the years ahead.

The Threat of Reconciliation: Remembering the Part D Vote

Democrats are threatening to use a budgetary procedure to accelerate the passage of broad health reforms in the next Congress. Republicans are already voicing protest, particularly with the idea of a new government-run insurance plan gaining momentum. But those concerns may fall on deaf ears.

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