Sen. Hillary Rodham Clinton, D-N.Y., says enrollees who hit the limit will discover “costs are going to increase dramatically and, in many instances, to the point where they can’t afford their medicines.”
“Politics are starting to trump reality on the ground,” Ghose says. “The reality is that millions of beneficiaries are receiving drug coverage that they never had before. In the bigger scheme, private health plans are providing peace of mind to millions of Americans who never had drug coverage before.”
“As bad as the bill is I don’t want to repeal it,” Stark says. “I’d like to see it improved.”

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“I’m now out over $600. August is going to come and I’ll be out another $88,” said J. Robert Edelson, a Fort Lauderdale retiree who works part-time to make ends meet. “We little guys in the middle are getting hurt. My car insurance is due and I could really use $300.”
Medicare hopes to resolve the glitches soon. “People should expect to see corrections by September,” Ashkenaz said. Social Security’s Lassiter said: “Once we get the data to process, we will refund all of that money. We owe it to the people we are serving to get this resolved as quickly as possible.”
Retiree Edelson said he is losing patience: “It’s already been how many months you guys are working on this and you still haven’t straightened it out. One blames the other and we’re out all this money.”

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“ViPS is pleased to be working with CMS on this feasibility test,” said Arthur Lehrer, President, ViPS. “We look forward to partnering with WebMD to further support CMS as it works towards meeting the President’s vision of electronic health records for all Americans within the next 10 years.”
“Our work on this important CMS project reflects WebMD’s commitment to providing consumers with personalized health information,” said Wayne Gattinella, CEO, WebMD. “By providing a secure, easily accessible and up to date health record of a person’s health history, WebMD can help people better manage their health, while improving care and health outcomes.”

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“Medicare’s deeming program provides real value to the health care system, by streamlining the review process for health plans that have demonstrated their commitment and ability to deliver quality care,” said NCQA President Margaret E. O’Kane. “We’re pleased to continue this vital public-private partnership with CMS and our Accredited plans.”
“Our partnership with NCQA over the past four years has helped to ensure that Medicare Advantage managed care plans provide their enrollees with appropriate care and the high level of service they deserve.” said CMS Administrator Mark McClellan, M.D., Ph.D. “Medicare beneficiaries in PPOs will now have the same benefits through our expanded collaboration with NCQA.”

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“Then they realize it’s no mistake, and they’re devastated,” she said. “They don’t know where to get the money. Many pull out their credit cards and say they’ll worry about it later.”
“I was shocked when my druggist told me I owed $200 more than last month,” said Mary Hitt, who is 67 and lives in Dallas. “After I wrote a check covering my prescriptions, I had $6 left in my account.”
“When people shopped for drug plans, they looked at premiums, deductibles and the drugs that were covered,” said Terry Warner, who owns TexMeds in Richardson, a company that sells insurance to seniors. “Most didn’t focus on the doughnut hole.”
“This year, many seniors didn’t enroll in a drug plan until May, so they’ll never hit the doughnut hole by the end of the year,” Cubanski said. “Next year, their drug costs will start accumulating on January 1, and they’ll be more likely to reach the gap.”
“I can’t feel good about my drug savings anymore because I know they’ll end someday.”

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According to the report, which analyzes CMS data, concerns about decreased access to providers “were heightened in 2002″ when Medicare physician payments were reduced 5.4% to lower spending increases. However, the report finds that no more than about 7% of beneficiaries have experienced “a major access difficulty.”
“Reprinted with permission from kaisernetwork.org You can view the entire Kaiser Daily Health Policy Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/healthpolicy . The Kaiser Daily Health Policy Report is published for kaisernetwork.org , a free service of The Henry J. Kaiser Family Foundation. � 2006 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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