November 24, 2003
Last May, 230 determined Society volunteers visited congressional offices in Washington, pressing the arguments in person. By early summer, the Senate version of the Medicare Rx Drug Act (S. 1) included language that provides transitional coverage during 2004-05 for all four of these MS therapies, whether self-administered or not.
The coverage called for in the Senate bill would expire when the overall Medicare Rx benefit (which will be called Medicare Part D) is implemented. This is expected in 2006. If enacted, people with MS who are insured by Medicare would pay 20% of the cost for their diseasemodifying drug, after a $100 annual deductible during 2004-05. In 2006, coverage would shift to Medicare Part D, and people with MS would have the same coverage for their prescription drugs as everyone else. The coverage will be whatever Congress enacts.
"Having interim coverage in S. 1 would be a major victory for us, but we're not there yet, " said Susan Sanabria, vice president for Advocacy at the Society, as this magazine went to press in the summer. Stiff conference committee negotiations to reconcile big differences between the Senate bill and the one passed by the House had begun. "But we are well-situated for negotiations because our advocates have made Congress aware of our immediate need," Sanabria said. 13#vety=2;enum=0;<ETXT> Homebound Rule watchers (see January-March 2003 InsideMS) have another reason to follow the progress of House-Senate negotiations over this Medicare reform bill. S. 1, the Senate bill, contains a provision to test a more open definition of "homebound" in three states for two years, to see if costs escalate inappropriately if some restrictions are relaxed.
Medicare currently pays for personal care assistance for people who
are homebound-using a definition of "homebound" that generally prevents
recipients from leaving their residences for any purpose except medical
care, adult day care, or religious services.
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