HA545 Kaplan
Advocacy and Public Policy Making
HA545- Health Policy
Kaplan University
Introduction
The purpose of this essay is to discuss Medicare Part D, as well as the influence of the various interest groups and governmental entities during this process. This essay will discuss both the policy process and the policy environment (the key players involved and other circumstances that shaped this policy-making effort), how stakeholder groups influenced the final outcome of Medicare Part D legislation, the specific strategies and tools that were used most effectively, and if the fact that Medicare Part D passed corresponds with my understanding of policy and politics.
Medicare Part D, also called the Medicare prescription drug benefit, is a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries in the United States. Enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006 (Wikipedia, 2010). In December 2003, the Medicare Prescription Drug, Improvement and Modernization Act (MMA) became law. The act created the Medicare Part D drug benefit to provide drug coverage to elderly and disabled people who did not previously have it. The stand-alone prescription drug plans that are the lynchpin of the program did not previously exist. The structure of the program is clearly intended to increase the role of private plans in Medicare (The Commonwealth Fund, New York, 2006). Prescription drug coverage under Medicare Part D will not be offered directly by Medicare but by private prescription drug plans and Medicare Advantage organizations. The law outlines the standard benefit, but the private plans can modify the benefit design. The private plans set their premiums, design their own formularies and are free to use cost management tools such as prior authorization, step therapy, or quantity limits. Medicare
HA545- Health Policy
Kaplan University
Introduction
The purpose of this essay is to discuss Medicare Part D, as well as the influence of the various interest groups and governmental entities during this process. This essay will discuss both the policy process and the policy environment (the key players involved and other circumstances that shaped this policy-making effort), how stakeholder groups influenced the final outcome of Medicare Part D legislation, the specific strategies and tools that were used most effectively, and if the fact that Medicare Part D passed corresponds with my understanding of policy and politics.
Medicare Part D, also called the Medicare prescription drug benefit, is a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries in the United States. Enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006 (Wikipedia, 2010). In December 2003, the Medicare Prescription Drug, Improvement and Modernization Act (MMA) became law. The act created the Medicare Part D drug benefit to provide drug coverage to elderly and disabled people who did not previously have it. The stand-alone prescription drug plans that are the lynchpin of the program did not previously exist. The structure of the program is clearly intended to increase the role of private plans in Medicare (The Commonwealth Fund, New York, 2006). Prescription drug coverage under Medicare Part D will not be offered directly by Medicare but by private prescription drug plans and Medicare Advantage organizations. The law outlines the standard benefit, but the private plans can modify the benefit design. The private plans set their premiums, design their own formularies and are free to use cost management tools such as prior authorization, step therapy, or quantity limits. Medicare
References: AARP . (2008). Medicare I. Retrieved from http://aarp.typepad.com/socialsecurity/medicare/index.html American Health Line. (2009). Healthline. Retrieved from http://www.nationaljournal.com/: http://www.nationaljournal.com/pubs/healthline NCHSD. (2005). Medicare Part D: Outreach Strategies. Retrieved from www.nchsd.org: www.nchsd.org/libraryfiles/MedicarePartD/PartD_Call050305. The Commonwealth Fund, New York. (2006). US Medicare Prescription Drug Coverage. Retrieved from US Medicare Prescription Drug Coverage: http://hpm.org/en/Surveys/CMWF_New_York__USA/07/US_Medicare_Prescription_Drug_Coverage.html Wikipedia. (2010). Medicare Part D . Retrieved from http://en.wikipedia.org/wiki/Medicare_Part_D