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As the U.S. Congress continues to search for an agreement on the form of a Medicare prescription drug benefit, the Commission has two new reports related to the debate.
This Briefing Note explores the issues presented for the design and administration of a new Medicare drug benefit by dually eligible nursing facility residents. Issue Paper (.
Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration.
Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs. These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).
This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country.
The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to Medications This report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements.
This paper, by Joy Pritts of the Health Policy Institute at Georgetown University, looks at issues related to drug plan marketing activities and privacy under the MMA. Issue Brief (.
Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Because women have longer life expectancies than men, more than half (57%) of the people covered by the program are women.
This report, prepared by Marilyn Moon of The Urban Institute and Robert Friedland and Lee Shirey of Georgetown University's Center on an Aging Society, reviews the income and assets of the current Medicare population, provides an overview of asset tests used to determine eligibility for programs assisting low-income Medicare beneficiaries, and considers how alternative policy…
This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available.
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