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Nursing home providers anticipate changes to the Medicare Part D prescription drug program now that Democrats have gained control of the House and the Senate.

Democrats are likely to consider filling the so-called “doughnut hole” in the Medicare prescription drug coverage. This kicks in when beneficiaries incur expenses beyond $2,250, up to $5,100. Providers also predict that Democrats during the 110th Congress will make a big push to permit the federal government to negotiate prices directly with pharmaceutical companies under Medicare Part D, much like the Department of Veterans Affairs does to get its lower cost prescription drugs.

But the administration is likely to push back. Michael Leavitt, secretary of the Department of Health and Human Services, said that the administration will fight efforts requiring the federal government to negotiate directly with drug companies over drug prices. Such a move would lead to government-run healthcare, he said.