New report damning to Part D private insurers

October 17, 2007

A new report requested by Rep. Henry Waxman finds that private insurers are not operating their Medicare Part D programs efficiently.

A new report charges that private insurers that operate the Medicare Part D plans are wasting billions of dollars in five ways:

  • charging high administrative expenses
  • failing to negotiate significant manufacturer rebates
  • not passing on rebates to beneficiaries in coverage gaps
  • using drug price formulas that leave enrollees vulnerable to price increases
  • having a mixed record in promoting generics

Prepared for Rep. Henry A. Waxman (D, Calif.), chairman of the Committee on Oversight and Government Reform, the report claims to provide for the first time proprietary data from 12 insurers covering 18 million beneficiaries. Following the publication of the report, many legislators expressed outrage over the Part D waste and failure to pass on rebates. The Pharmaceutical Care Management Association issued a response to the report. It said that while there is always room for improvement, pharmacy benefit managers are proud of their performance and most seniors are pleased with their Part D plan.

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