American College of Physicians: Internal Medicine — Doctors for Adults ®

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Policy briefs

From the March ACP Observer, copyright © 2006 by the American College of Physicians.

ACP touts Medicare 'buy in' to extend coverage

The College has released a new position paper, outlining an ambitious plan to extend health care coverage through Medicare to adults age 55-64.

While nondisabled adults under age 65 are currently not eligible for Medicare, the ACP paper points out that half of all adult Americans in this age range make less than 200% of the federal poverty level--and that 2.6 million people in this age category are uninsured.

The paper, entitled "Developing a Medicare Buy-in Program," argues that covering these individuals would save taxpayers money in the long run by ensuring that chronic disease is managed outside hospitals and by providing key preventive services.

The paper focuses on four key points:

  • Financing. ACP advocates for financing the plan through higher payroll taxes and other federal revenue sources, or by linking premiums to income.

  • Subsidies for lower-income recipients. The paper argues that a buy-in should initially target Americans age 55-64 whose income falls between 100% and 200% of the federal poverty level.

  • Eligibility. The paper proposes making all adults age 55-64 eligible for a Medicare buy-in plan, regardless of their insurance status.

  • Enrollment. The College recommends that any such program should provide enrollees with the full menu of Medicare benefits, including new prescription drug coverage.

The paper is online.

ACP calls for changes in Part B drug-buying program

The College has urged the Centers for Medicare and Medicaid Services (CMS) to modify its final rule on a new alternative to purchasing drugs administered in physician offices.

Under the new competitive acquisition program, which will take effect this July, drug manufacturers--not physicians--will bill Medicare to be reimbursed for those drugs.

In a January letter to the CMS, the College pointed out several modifications that need to be made to the rule. Those include establishing a minimum 30-day claims-billing period after drugs have been administered, instead of the 14-day period now included in the rule; and paying physician practices more to cover administrative costs.

The letter is online.

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