Today’s Hot Topics in Medicare News

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Medicare drug prices soar at 10 times rate of inflation, report says

BY CNN WIRE: The prices of the 20 most commonly prescribed brand-name drugs for seniors have risen nearly 10 times more than the annual rate of inflation over the past five years, according to a congressional report released Monday.

“Can you imagine if you went to an auto dealership and last year’s exact model was being sold at a 20 percent mark-up, and then you went back the next year and it had happened again?” said Sen. Claire McCaskill, D-Missouri, who released the report as part of a years-long investigation into escalating drug prices.

“That’s exactly what’s happening in the prescription drug industry, where the cost of identical drugs skyrockets year after year.” (read more)

Scrutinizing Medicare coverage for physical, occupational and speech therapy

BY JUDITH GRAHAM: For years, confusion has surrounded the conditions under which older adults can receive physical, occupational and speech therapy covered by Medicare.

Services have been terminated for some seniors, such as those with severe cases of multiple sclerosis or Parkinson’s disease, because therapists said they weren’t making sufficient progress. Others, including individuals recovering from strokes or traumatic brain injuries, have been told that they reached an annual limit on services and didn’t qualify for further care.

Neither explanation stands up to scrutiny. Medicare does not require that older adults demonstrate improvement in order to receive ongoing therapy. Nor does it limit the amount of medically necessary therapy, for the most part. (read more)

Medicare is cracking down on opioids. Doctors fear pain patients will suffer.

BY JAN HOFFMAN: Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of the 43.6 million beneficiaries of the program’s drug plan had been prescribed the painkillers.

Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction.

But the proposal has also drawn a broad and clamorous blowback from many people who would be directly affected by it, including patients with chronic pain, primary care doctors and experts in pain management and addiction medicine. (read more)

Your financial future: Beware of scams with new Medicare cards

BY GARY BOATMAN: … SS numbers will be replaced by an 11-digit randomly generated number. Both new and old cards will be accepted for a year. It is recommended that you destroy your old card once you receive a new one. The new cards are just starting to be released and there is already fraud happening. There is no charge to receive a new one. There have been some reports that seniors have received a telephone call requesting a fee. Medicare will not usually call you on the telephone. They will send you letters in the mail.

There have also been reports of someone getting calls stating that the person must buy prescription drug coverage to get a new card. Most advantage plans include medicines and you buy Part D coverage for pharmaceuticals either when you first go on Medicare or during annual enrollment between Oct. 15 and Dec. 7. (read more)

It only feels like we’re paying more for health care

BY DAVID NATHER: Think you’re getting stuck with bigger bills for your routine medical costs, like copayments and deductibles? You might want to look at this chart, based on research from the Medicare Payment Advisory Commission. It shows that, back in 1976, our disco-dancing ancestors paid a way bigger share of own their health care costs than we do today.

Between the lines: If you’re wondering how that can be true, we’ve got some thoughts from Matthew Fiedler of the Brookings Institution, and the MedPAC report has some clues too. The basic answer is that health coverage has gotten more comprehensive than it was 40 years ago.

Yes, but: Out-of-pocket costs don’t include premiums, so it’s possible that we’re just paying for our health care in other ways. (read more)

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