Bush orders drug plans to keep co-pays to $5 or less for dual eligibles
President Bush this week instructed prescription drug plans to provide a 30-day supply of any drug that a Medicare beneficiary was taking before the start of the prescription drug benefit on Jan. 1. He also told plans they cannot charge poor beneficiaries more than $5 for a covered drug.Bush issued the directives after several states declared public health emergencies and reinstated Medicaid programs to bridge drug access problems to beneficiaries, including dual eligibles, or those eligible for Medicare and Medicaid. The majority of the nursing home population comprises dual eligibles.
About 20 states, including California, Illinois, Ohio, Pennsylvania and all of New England, have stepped in to cover drugs that the federal government was expected to pay. California officials estimate that 200,000 of the state's 1.1 million low-income Medicare beneficiaries had trouble getting their medications.
States took action, in part, because drug plans charged dual eligibles copayments that were higher than expected. Bush's directive requires that plans not charge more than $2 for a generic and $5 for a brand-name drug.
Meanwhile, both Republicans and Democratic lawmakers have criticized the Bush administration for the troubled launch of the program.