Durbin Calls on HHS To Warn Seniors Enrolling in Medicare Drug Benefit About Changing Drug Prices

DURBIN CALLS ON HHS TO WARN SENIORS ENROLLING IN MEDICARE DRUG BENEFIT ABOUT CHANGING DRUG PRICES

U.S. Senator Dick Durbin (D-IL) today called on the Department of Health and Human Services (HHS) to post a warning to inform seniors that drug prices quoted on the Medicare Prescription Drug Plan Finder website can change.

In a letter to HHS Secretary Michael Leavitt, Durbin urged the Secretary "[t]o place a prominent notice on the Centers for Medicare and Medicaid Services (CMS) website informing Medicare beneficiaries that the drug prices quoted on the Medicare Prescription Drug Plan Finder can change…"

Durbin noted that a constituent who used the Plan Finder website saw the estimated annual cost of her prescription drug plan increase from $2,691.69 to $3,942.18 in less than two weeks.

"While millions of American seniors are busy trying to figure out which drug plan best meets their needs and fits within their budget, the drug prices are changing," Durbin continued. "I have advised my constituents to take their time and study each plan carefully before making a decision. What I now realize is that the plan that is the best for them this week may not be the best plan next week. Yet they are being asked to lock in a decision for a year based on prices that could change tomorrow."

Durbin asked, "If seniors are locked into a plan for a year once a plan is chosen, why are insurance plans able to drastically change prices at their whim?"

Durbin called on the Secretary to remedy the situation, labeling it unacceptable. "Seniors diligently compare plans and decide on the best plan now, unaware that they may be charged a different price in January; and possibly another price in February and another in March. This could deal a significant financial blow to seniors on a fixed income."

The full text of the Durbin's letter to Secretary Leavitt appears below.

November 29, 2005

The Honorable Michael Leavitt
Department of Health and Human Services
Hubert Humphrey Building, Room 416G
200 Independence Ave., SW
Washington, DC 20201

Dear Secretary Leavitt:

I am writing to urge you to place a prominent notice on the Centers for Medicare and Medicaid Services (CMS) website informing Medicare beneficiaries that the drug prices quoted on the Medicare Prescription Drug Plan Finder can change, and that seniors should not expect that the prices they find on the website will remain valid throughout the year, unless they choose a plan with co-payments rather than coinsurance.

While millions of American seniors are busy trying to figure out which drug plan best meets their needs and fits within their budget, the drug prices are changing. I have advised my constituents to take their time and study each plan carefully before making a decision. What I now realize is that the plan that is the best for them this week may not be the best plan next week. Yet they are being asked to lock in a decision for a year based on prices that could change tomorrow.

One of my constituents called my office asking for assistance in choosing a plan. She is taking Arthrotec, Fosamax, K-Tabs, Lasix, Prevacid, and Trental. The Plan Finder on November 17, 2005 offered a list of appropriate prescription drug plans, including Medicare Rx Rewards Premier, which had an estimated annual cost of $2,691.69. My staff re-checked the same drug list on the Plan Finder less than a week later, on November 22, 2005, and found the same plan was then estimated to have an annual cost of $3,844.49 - an increase of $1,152.80 from the week before. We checked the drug list again on November 28, 2005 and this time, Medicare Rx Rewards Premier was estimated to have an annual cost of $3,942.18—an increase of more than $1,250 in the plan's annual cost since the Plan Finder website was first consulted 11 days earlier.

In another instance, my staff checked a Humana plan for a zip code in Hillsboro, IL at 3:10 p.m. and again at 5:02 p.m. on November 22, 2005 and the estimated annual cost had decreased more than $70 in two hours. This fluctuation in the final cost is unexplainable, as all of the data provided for drug prices, deductibles, and monthly premium costs was the same in both instances. All of this data is attached for your review.

A call to the Congressional Affairs office at CMS revealed that pricing data is entered into the Plan Finder on a weekly basis. If seniors are locked into a plan for a year once a plan is chosen, why are insurance plans able to drastically change prices at their whim?

This situation is unacceptable. Seniors diligently compare plans and decide on the best plan now, unaware that they may be charged a different price in January; and possibly another price in February and another in March. This could deal a significant financial blow to seniors on a fixed income.

The CMS website is currently doing a poor job of educating seniors on the possibility of price changes. The site says "costs will vary depending on which drug plan you choose," but nowhere does it point out that costs within a plan could change. Under the heading "How Much Will the Plans Cost," you should spell out clearly that prices could fluctuate, not simply describe the structure of the benefit as though prices will be static.

I urge you to remedy this situation before the benefit begins so that seniors understand what they may be paying. I also urge you to take action to rein in this drug price variability within individual drug plans, or to explain to Congress why you are unable to do so and work with us to correct this flaw in the program.

Sincerely,

Richard J. Durbin
United States Senate

http://durbin.senate.gov/record.cfm?id=249354&&