Program Description
The Medicare Part D prescription drug benefit was enacted through controversial legislation called the Medicare Prescription Drug Improvement and Modernization Act—the Medicare Modernization Act (MMA), for short—passed by Congress in 2003.[i] Up until then, Medicare beneficiaries had not had access to a comprehensive Medicare-sponsored prescription drug plan since Medicare was created in 1965. Most beneficiaries had some type of outpatient drug coverage provided through retiree health programs, state-based Medicaid prescription drug coverage, private Medigap policies, state pharmacy assistance programs (SPAPs), government programs sponsored by the Department of Defense or Department of Veterans Affairs and the Federal Employees Health Benefits Program. In all, 43.4 million Medicare beneficiaries became eligible for Medicare Part D benefits in 2006.[ii]
[i] Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. 108-173 (Dec. 8, 2003) U.S.C.A. § 1395w-101 et seq. (2004 supplement), 42 C.F.R. §423.506.
[ii] US Department of Health and Human Services. Over 38 million people with Medicare now receiving prescription drug coverage [news release]. June 14, 2006. Available at: http://hhs.gov/news/press/2006pres/20060614.html. Accessed November 28, 2006.
by Marsha K. Millonig, RPh, MBA, and Mary Jo Carden, RPh, JD
Marsha Millonig is the President of Catalyst Enterprises, LLC, a health care consulting firm. The company specializes in projects that help drive pharmacy, distribution and manufacturing organizations to become more efficient and/or value-added providers of health care to improve patient health outcomes. Marsha served as VP, Research and Information for the Healthcare Distribution Management Association (HDMA) and headed the philanthropic HDMA Healthcare Foundation until 2002. Prior to HDMA, Marsha worked with chain pharmacy executives on operations, professional & government affairs, and education and practice issues for the National Association of Chain Drug Stores (NACDS).
Mary Jo Carden is the President and Founder of Carden & Associates, a boutique health care policy and advocacy firm founded in 2006. Prior to this, she served as Principal of Dumbarton Group and Associates, LLC, a policy and advocacy firm she co-founded in 2003. Prior to her consulting experience, she held positions for eight years with the American Society of Consultant Pharmacists (ASCP), including Director of Government Affairs and practiced community pharmacy. Ms. Carden provides health care clients across the United States with guidance, research, advice, strategic planning, and advocacy on health policy and legal issues, including the Medicare Part D and B programs and other public and private pharmacy reimbursement programs; medication therapy management programs; Medicare post -acute care; and controlled substance issues. She also travels throughout the United States to speak to corporations and associations regarding these issues.
Faculty Disclosure
The NACDS Foundation has a conflict of interest policy that requires course faculty to disclose any real or apparent commercial financial affiliations related to the content of their presentations/materials. The authors of this program has no conflicts of interest.
Disclaimer
The authors, sponsor, and publisher of this continuing education program have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available knowledge at the time of accreditation of this continuing education program.
Learning Objectives
At the conclusion of this program, participants should be better able to:
- Describe issues and challenges relating to implementation of the Medicare Part D benefit in 2007 and the impact on patients served by community pharmacy.
- Explain important aspects of plan designs and beneficiary choices for 2006 in order to better assist Medicare beneficiaries.
- Identify important changes to the Medicare Part D program for 2007 and explain the impact on community pharmacy.
Target Audience
This program is appropriate for pharmacists in any practice setting.
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