Medicare Compensation Legislation Analysis

Medicare Part D is the portion of Medicare that covers prescription drugs and is separate from

A highly motivated and dedicated analyst with over two years’ experience in start-up Research Office at Huron Consulting Group. Working on developing Medicare Coverage Analysis (MCA) and study budgets for clinical research protocols in various therapeutic areas such as oncology, cardiology, pediatrics, and internal medicine for multiple clients across the country. A meticulous eye for detail in assisting clients with mitigating clinical research billing compliance risks, by interpreting and applying Medicare/Medicaid coverage decisions and national care guidelines to determine correct billing to insurance providers and research study sponsors. A confident communicator with an emphasis on utilizing the strengths of colleagues and creating an

It was a defining moment just over a decade ago that Medicare Part D, or the Medicare prescription drug benefit, became effective. A group of officials and assistants crafted this legislation to aide those seniors that had troubles getting their prescriptions every month. The program also made millions upon millions for pharmaceutical companies. The various stakeholder groups influenced the final outcome of this legislation to the point that if they were not involved, the country may not have ever been introduced to Medicare Part D.

The cost of health care has been at the forefront of politics for years. It is one of the most talked about topics not just in political venues but also country wide. Every American has an opinion on how our economy can be fixed and they are passionate about health care reform. The price of insurance alone causes many Americans to not have coverage. For those that can afford coverage, the struggle to pay co pays is immensely crippling their bank accounts. Of these burdens on Americans today, the most frightening fact lies in the cost of prescription medications.

Psychiatric Diagnostic B. Geniatric daycare C. Marriage counseling D. Transportation E. Meals Prior to 2010, Medicare patients were required to pay a 50 % co-payment Prescription drugs are prescribed with part D benefits and are a large part of the healthcare system. CMS will reinforce to require a requirement that Medicare part D plans may not cover drugs if the doctors are not enrolled in Medicare. (CMS.gov 2015). Preventive services range from the Adults, to women, to children. For adults, there is a screening for alcohol misuse and the counseling.

Medicare Part D Drug Plan was created by Congress in 2003 to aid the elderly, disabled, and sick persons in affording their medication. Coverage for the drug plan went into affect January 1, 2006. This plan was called the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) (Cassel, 2005). The final bill that passed, was influenced by drug-company and health insurance lobbyists and focused mainly on the needs of those industries instead of the seniors it was meant to serve (Slaughter, 2006). These plans are operated by insurance companies and some private companies that have been approved by Medicare. Part D is optional only if a person carries health insurance that includes prescription coverage. If at retirement

Medicare Part D was created under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. (Medicare Part D, 2011). It is also known as the prescription Drug Plan. This plan was created to help cover cost of prescription drugs, and people who have the original Medicare or Medicare Advantage are eligible to enroll (Medicare Part D, 2011). Prescription drug coverage is only offered through HMOs, PPOs, and PFFSs and by some private companies who contract with Medicare through individual plans (Medicare Part D, 2011). Private companies are allowed to create their own customized benefit plan as long as the plan is as good as the plan outlined in the 2003 Medicare Act (Medicare Part D, 2011).

Since the late 1980s, Medicare has reimbursed physician services using the Medicare Physician Fee Schedule (MPFS), which encompasses 10,000 procedure codes. Each code is assigned resource-based relative value units (RVUs), which are designed to reflect physician work, practice expense, and malpractice expense. To adjust for local differences in cost of living, each RVU is modified using geographic practice cost indexes (GPCIs) and then converted to dollars using a “conversion factor.” This system rewards physicians who produce a high volume of services; not surprisingly, Medicare Part B expenditures have grown rapidly.

Medicare Part D is the prescription drug plan. There are various options under this portion of Medicare and depending on the one that your mother has chosen would base the amount of coverage that she would receive for prescription medications. This does not necessarily cover the full cost of the prescription medications; there are deductibles and copayments that must be met.

The passage of the Medicare Drug Price Negotiation Act will also inadvertently increase access to many types of medications for individuals who qualify for Medicare Part D. There is a clause within the bill that would establish rebates to be paid by pharmaceutical companies for low-income beneficiaries. These rebates, in addition to lowered costs, would considerably lessen the financial burden placed on low-income beneficiaries. This will allow more individuals greater access to expensive medications. As an example, each year, financial reasons hinder about 16% of diabetic Part D beneficiaries from filling at least one of their prescriptions (Williams, Steers, Ettner, Mangione, & Duru, 2013). This increase in access will help mitigate the occurrence of cost-related nonadherence to prescription medications, and other such consequences

The purpose of this essay is to discuss Medicare Part D, as well as the influence of the various interest groups and governmental entities during this process. This essay will discuss both the policy process and the policy environment (the key players involved and other circumstances that shaped this policy-making effort), how stakeholder groups influenced the final outcome of Medicare Part D legislation, the specific strategies and tools that were used most effectively, and if the fact that Medicare Part D passed corresponds with my understanding of policy and politics.

Medicare Part D is prescription drug coverage. It’s the newest part in Medicare. It adds prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare PPS plans, and Medicare Medical Savings plans. Beneficiaries choose the drug plan and pay a monthly premium.

The major purpose of this work is to completely discuss about the Medicare Part D which will set an influence on the different interest groups and all the entities of government which have been set under the policy changing process. There has been a complete set environment which involved and shape the policy to make efforts as to how all the groups of the stakeholders are influences with the Medical Part D. All the legislation and the specific strategies are made in correspondence to the politics. (Powell et al., 2015). The Medicare Part D is also said to be Medicare prescription drug benefit which directs to setting the United States Federal government programs to work on the subsidizing costs of all the drugs of prescription which insure premiums for the Medicare in US. There is a great enactment which has been based on Medicare Modernization Act of 2003. In December 2003, there are major Medicare Prescriptions which have become into the Improvement and Modernisation Act to become a proper law. There has been a great benefit from the drugs which provides an entire coverage to all the disables and the elderly people who could not have the ability to manage it.

What is Medicare Part D? Medicare Part D, which is also known as the Medicare prescription drug benefit, is a United States federal government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries (medicareinteractive.org, 2016). In this paper I will synthesize my understanding of why Medicare Part D passed and the influence of the various interest groups and governmental entities during the process, as well as discuss how various stakeholder groups influence the final outcome of Medicare Part D legislation, what the specific strategies and tools that were used most effectively as well as advise if the Medicare Part D passed corresponds with my understanding of policy and

The purpose of this essay is to discuss Medicare Part D, as well as the influence of the various interest groups and governmental entities during this process. This essay will discuss both the policy process and the policy environment (the key players involved and other circumstances that shaped this policy-making effort), how stakeholder groups influenced the final outcome of Medicare Part D legislation, the specific strategies and tools that were used most effectively, and if the fact that Medicare Part D passed corresponds with my understanding of policy and politics. Medicare Part D, also called the Medicare prescription drug benefit, is a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries in the United States. Enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006 (Wikipedia, 2010). In December 2003, the Medicare Prescription Drug, Improvement and Modernization Act (MMA) became law. The act created the Medicare Part D drug benefit to provide drug coverage to elderly and disabled people who did not previously have it. The stand-alone prescription drug plans that are the lynchpin of the program did not previously exist. The structure of the program is clearly intended to increase the role of private plans in Medicare (The