To the Center of Medicare & Medicaid Services

CMS’ recent Medicare Part D proposed rule will reduce consumer choice and impose higher costs on beneficiaries and taxpayers.  Medicare Part D has been a successful program and weakening it will result in declining patient health and increased Medicare costs.  Healthcare Leadership Council is circulating a comment letter to CMS on this important issue.   If your organization (organizations only, no individuals please) would like to sign the HLC letter, please email Jennifer at [email protected].

February 18, 2014 Final Draft

The Honorable Marilyn B. Tavenner, Administrator
Centers for Medicare & Medicaid Services
U.S. Department of Health and Human Services
Attention: CMS-4159-P
P.O. Box 8013
Baltimore, MD 21244-8013

Dear Administrator Tavenner:

Thank you for the opportunity to share our views on CMS’s proposed changes to the Medicare Part D prescription drug program. The undersigned organizations reflect a wide breadth of companies and organizations representing, among others, multiple healthcare sectors, employers and patients that share your commitment to a strong Medicare that meets the healthcare needs of its beneficiaries.

We are deeply concerned that the proposed rule is inconsistent with the spirit and purpose of Medicare Part D, represents unnecessary changes to programs that are already extraordinarily effective in containing costs and, most importantly, will severely impede beneficiaries’ access to affordable health plans and medicines. We urge you in the strongest terms to withdraw the proposed rule that would have unintended consequences for seniors and beneficiaries with disabilities.

As you know, Medicare Part D is an undeniable success story. The Part D program has maintained stable, affordable average monthly premiums, enjoys a 90 percent approval rating among beneficiaries, and has program costs that are more than 40 percent below original Congressional Budget Office projections.

The proposed rule threatens to disrupt the positive effect the program is having on beneficiaries’ health and the Medicare program as a whole. Each undersigned organization has concerns about specific provisions, but there are overarching issues on which we are unanimous in our objections.

First, the rule would significantly reduce beneficiaries’ choice of plans and medicines and lead to disruptions in care. Millions of seniors and beneficiaries with disabilities would lose their current plan of choice or face changes in coverage. Beneficiaries value choice in the Part D marketplaces, and a range of options promotes both competition and innovation in benefit designs that improve the way beneficiaries access their Part D benefits and services.

Second, it would fundamentally transform the market-based competitive models that have made the Part D program highly successful. The rule would dramatically expand the federal government’s role in Medicare Part D despite the fact that there is no compelling reason for doing so. Reshaping Part D in this way will neither improve quality and affordability, nor incentivize plan innovation.

Third, the proposed regulation will impose a large cost burden that will impede the ability of plan sponsors and other health sectors to continue offering affordable, quality care to patients. These new costs will drive higher premiums for millions of beneficiaries and lead to higher costs for Medicare without tangible gains in service or quality for beneficiaries.

And, finally, the timing of this omnibus proposed rule has created great uncertainty as many of our organizations and the companies we represent have already begun preparations for the 2015 plan year. Many of these organizations are also currently devoting significant resources to ensuring the success of the health insurance exchanges, and this would represent a tremendous additional burden. With the June bid submission deadline in mind, we urge you to withdraw the proposed rule in a timely manner in order to minimize disruption for beneficiaries when it comes time to make plan selections in October.

In summary, the Part D proposed rule will not only fail to achieve its intended goals but will reduce choice and impose higher costs on beneficiaries and taxpayers. Medicare Part D has succeeded beyond expectations in enhancing the health and well-being of enrollees. Weakening these programs will result in a less healthy patient population and, consequently, increased Medicare costs in the long term.

Consequently, we urge CMS to withdraw the proposed rule that, as written, would fundamentally undermine the success of the Part D program for beneficiaries. We look forward to working with you to assure that Medicare continues to offer affordable, high-quality health coverage and accessible medications. It is a privilege to work with you to meet the needs of current and future Medicare beneficiaries.

Sincerely,

Aetna
America’s Health Insurance Plans
Biotechnology Industry Organization
Cigna
Express Scripts
Generic Pharmaceutical Association
The Global Genes Project
Healthcare Leadership Council
Pharmaceutical Care Management Association
Pharmaceutical and Research Manufacturers of America
WellPoint