House Energy and Commerce Health Panel Urged to Back S. 1107, The Home and Community Services Co-payment Equity Act
Contact:
Donna Doneski, AHCA/NCAL, (202) 898-6321
For Immediate Release
May 16, 2007
Washington, DC – Stressing the fact that dually eligible Medicare beneficiaries in assisted living and other home-like settings often have just a small monthly personal needs allowance to use for their prescription drug co-payments, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) urged the U.S. House Energy and Commerce Health Subcommittee to introduce and pass legislation, like that introduced in the Senate, to bring equity to these low-income seniors by eliminating their Medicare Part D co-payments.
Testifying on behalf of AHCA/NCAL, Gail Clarkson, Chief Executive Officer of The Medilodge Group, said the Home and Community Services Co-payment Equity Act (S. 1107), would eliminate Part D co-pays for dually eligible individuals who are covered under both Medicare and Medicaid and living in home and community based settings and put them on par with those in nursing facilities who have no co-pays under Medicare Part D. Responding to a question from Health Subcommittee Chairman Frank Pallone (D-NJ), Ms. Clarkson explained that there is little difference between the nursing home resident and a dually eligible beneficiary living in an assisted living residence. Like nursing homes residents, assisted living residents often require, on average, nine medications per day. “We urge members of this Committee to introduce companion legislation to S. 1107,” she said.
“Programs like Medicare Part D and the Low Income Subsidy are critical parts of the health care safety net in this country, but what I have found in practice is that accessing these programs can be challenging—as was the case with the auto-enrollment of dually-eligible nursing home residents under Medicare Part D,” testified Clarkson, whose Medilodge Group operates fourteen skilled nursing and four assisted living facilities employing 2,500 individuals and cares for more than 2,300 patients and residents across Michigan.
AHCA/NCAL continues to work closely with the Centers for Medicare and Medicaid Services (CMS) on implementation of Medicare Part D, and Ms. Clarkson noted that she is proud to say that no patient or resident being cared for in a skilled nursing facility went without his or her medication during the transition to the new prescription drug benefit.
“Our experience shows that can take effect in only a few weeks whereas it can be months before Medicaid eligibility is determined,” remarked Clarkson. Patients, families, and health care providers, she explained, are often unaware of these benefits, or even how the Medicare and Medicaid benefits work with respect to their long term care needs.
“AHCA/NCAL understands that retrofitting a new benefit is not easy,” Ms. Clarkson continued. “That’s why we have looked at ways to reform Medicare and Medicaid to better meet the needs of a swiftly aging baby boom generation. We are working to be transparent for consumers, and we ask CMS to be similarly transparent in the criteria it uses to oversee the care we provide. We also ask that CMS not place paperwork over patient care, and we thank Chairman Dingell and those who have already called on CMS to redress its final rule on blood glucose monitoring.”
Clarkson concluded, “AHCA/NCAL stands ready to work with your Committee and with all who have a stake in the future of our long term care delivery system.”
The American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) represents nearly 11,000 non-profit and proprietary facilities dedicated to continuous improvement in the delivery of professional and compassionate care provided daily by millions of caring employees to 1.5 million of our nation’s frail, elderly and disabled citizens who live in nursing facilities, assisted living residences, subacute centers and homes for persons with mental retardation and developmental disabilities. For more information, please visit www.ahca.org.