Medicare Pharmacy ‘Lock-in’ Proposal Moving in House
Legislation that includes a problematic Medicare pharmacy “lock-in” for beneficiaries considered at risk for prescription drug abuse is advancing in the House. At-risk beneficiaries would be those “identified through the use of clinical guidelines developed” by the Department of Health and Human Services in consultation with drug plans, community pharmacists, and other stakeholders. After determined NCPA advocacy efforts, lawmakers inserted language that cites community pharmacists specifically among the stakeholders and makes clear that patients under hospice care and in long-term care facilities would be exempted.
Lawmakers also added protections for “snow birds” so they wouldn’t be locked to a single pharmacy and could obtain their prescriptions when they move seasonally.
A new provision was added this morning would require the HHS Secretary to develop a process to consider complaints that are received from enrollees in a prescription drug plan regarding the lack of access to their medications due to a drug management program for at-risk beneficiaries.
The provisions are part of the 21st Century Cures Act, designed to boost drug research and improve the drug approval process. The House Energy and Commerce Committee plans to vote on the bill this week with an eye on a House floor vote in June. It is unclear at this time whether a similar the Senate bill will include any Medicare Part D-related provisions.
Filed under: General Problems
Pharmacies are ALWAYS out of my meds and I have to DRIVE around to find one with it, they won’t tell you on phone. This is CRAZY stupid.
It’s not just the fact that it’s now harder to obtain my NEEDED medications. The biggest problem that I am having is the fact that I’m being charged a co-pay/ deductible for every visit and325I can’t afford these extra charges.
I was diagnosed with degenerative disk disease with narrowing of the spinal column in both my neck and lower back approximately 7 years ago. At first I was simply treated with physical therapy, traction, electric stimulation therapy and pharmaceutical medications. My first doses of medications were 5mg flex . muscle relaxers as needed , 800mg Ibuprofen 3 times daily and 5/500 vicodin 1 tablet every 12 hours or as needed. I actually would often break my vicodin tablets in half and work through the pain.
Later on I was diagnosed with diabetes along with cardiovascular disease and fibromyalgia. Now my list of medications have started to grow, also the chronic Spinal pain began to become almost unbearable, my dose was increased for the medication containing Hydrocodone and kept being increased for may years. To date I am now prescribed Norco 10/325mg once every 4 hours, also in the last half of 2013 I was the subject of 8 different surgical procedures from spinal cord injections to the installation of spinal cord stimulators In both my neck and lower back.
Today I am almost 50 years old and unable to work anymore. I had attempted to return to work in March of 2014 but was unable to perform my daily work duties anymore. I had to file for disability at the age of 47 and it makes me sick. I worked 33 years of my life, rarely missing a day of work because I always knew that I needed to work so my family could live in a comfortable fashion. Now, I have to depend on my wife to support our family. This had always been my duty and I was extremely proud that my family never had to go without. Now my medical bills alone cost our household $526 per month, this includes health insurance, monthly doctors appointments and medications. These are out of pocket expenses, yes once my SSDI does come in things will be better but until then it’s really tight and it shouldn’t be. The day that Government started to practice medicine was the day that we started feeling the pressure.
Trust me, I do understand that the whole idea behind this change in my medical cost is because there are so many people and kids getting addicted to opioids, but that’s not the fault of us. There are too many drugs available on the street corners that aren’t coming from people like me. These drugs are coming from gangs and organized drug dealers that are either stealing then from people or smuggling them across the borders. If the DEA, ATF, FBI, CIA, DHS, FDA, INS and the elected and appointed officials would do their jobs and catch these dealers and smugglers instead of supporting them. Maybe hard working people in pain can live without the pain of being financially stressed. So my point is that the scope of the blame needs to be broadened.
It’s discrimination, plain and simple.