Proposed Medicare drug change stirs access worries

Washington Examiner, January 11, 2014

WASHINGTON — In a move that some fear could compromise care for Medicare recipients, the Obama administration is proposing to remove special protections that guarantee seniors access to a wide selection of three types of drugs.

The three classes of drugs — widely used antidepressants, antipsychotics and drugs that suppress the immune system to prevent the rejection of a transplanted organ — have enjoyed special "protected" status since the launch of the Medicare prescription benefit in 2006.

That has meant that the private insurance plans that deliver prescription benefits to seniors and disabled beneficiaries must cover "all or substantially all" medications in the class, allowing the broadest possible access. The plans can charge more for costlier drugs, but they can't just close their lists of approved drugs, or formularies, to protected medications.

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