LTC pharmacy groups want inclusion of more drugs under Medicare law

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Long-term care pharmacy organizations are urging Congress to take legislative action to include four classes of drugs that are currently excluded from the new Medicare outpatient drug benefit.

The American Society of Consultant Pharmacists, the Senior Care Pharmacy Alliance and Long-Term Care Pharmacy Alliance brought members to Washington D.C. last week for issue briefings and lobbying on Capital Hill. Some members asked for an amendment to the Medicare law to provide coverage for benzodiazepines, barbiturates, over-the-counter medications, and medications to treat weight loss.

ASCP warned lawmakers that the lack of coverage for these excluded drugs would hurt long-term care residents, especially "dual eligible" individuals (those covered by both Medicare and Medicaid). At-risk individuals need continued access to medications essential to the treatment of medical conditions like seizure disorders. Also, restricting access to the four classes of drugs would result in increased health costs, the organization said.

The Medicare Part D new drug benefit is voluntary for most eligible beneficiaries. However, it is mandatory for dual eligible individuals. Dual eligible individuals currently have access to most medications through Medicaid, but that Medicaid coverage will end on Jan. 1 to be replaced with a Medicare plan that excludes coverage for certain classes of medications. States' Medicaid programs will have the option of paying for the excluded drugs.