|
 U.S.
Medicare program scales back hospice drugs restrictions
Send a link to a friend
[July 19, 2014]
WASHINGTON (Reuters) - The
Obama administration on Friday backed down on
restrictions of private insurance coverage for hospice
drugs under Medicare, saying the regulations were
preventing some terminally ill patients from having
access to medicine.
|
|
 The Centers for Medicare and Medicaid Services (CMS) said it would
now require prior-approval for coverage of only four categories of
drugs: analgesics, anti-nauseants, laxatives and anti-anxiety drugs.
In a regulation announced in March, the government had required
prior approval for all hospice drugs under the Medicare Part D
prescription drug benefit.
“Based on discussions with stakeholders, we are adjusting our rules
so that beneficiaries enrolled in hospice will continue to have
access to their medications,” CMS spokesman Raymond Thorn said in a
statement.
The change follows a June meeting between officials and stakeholders
including hospice providers, insurers and pharmacies and patient
advocates who described the operational challenges of requiring all
hospice drugs to be approved before they could be dispensed.
On Friday, the agency acknowledged in a memo to stakeholders that
the March regulations were causing difficulties and "in some cases,
barriers to access for beneficiaries."
CMS issued the initial rule after an investigation by the Department
of Health and Human Services found that the Medicare program for the
elderly and disabled were paying twice for some drugs.
[to top of second column] |
Under Medicare's Part A hospital program, hospices receive daily
payments for each patient but are responsible for all drugs related
to a patient's terminal illness. Medicare Part D covers only
prescriptions and medications for curative conditions that are
unrelated to a terminal illness.
The four groups of drugs that remain subject to the restriction are
generally used to relieve discomfort in patients near the end of
life. CMS said it expects Part D claims for those treatments to be
very few, but said it would provide coverage under the program if a
provider simply stated that they were "unrelated" to the patient's
terminal illness.
(Reporting by David Morgan; Editing by Lisa Shumaker)
[© 2014 Thomson Reuters. All rights
reserved.] Copyright 2014 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
