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Durbin-Berry Bill Proposes Government Plan for Medicare Part D
On October 23, Sen. Richard Durbin (D-IL) and Rep. Marion Berry (D-AR) brought in the "Medicare Prescription Drug Savings and Choice Act" (S. 2219/H.R. 3932).
The Durbin-Berry bill would set up a Medicare-operated prescription drug plan that would be obtainable to all Medicare beneficiaries nationwide and would compete with the existing plans offered by the private sector. The HHS Secretary would be directed to negotiate directly with pharmaceutical manufacturers about prices paid for prescription drugs covered by the Medicare-operated plan. The bill as well would establish necessities for the formulary, formulary incentives, and appeals procedure under the Medicare-operated plan. The Agency for Healthcare Research and Quality (AHRQ) would be charged with evaluating the clinical advantage of covered Part D drugs and making suggestions to the HHS Secretary regarding which drugs ought to be included in the formulary of the Medicare-operated plan.
Other provisions of the bill establish necessities for the timely payment of pharmacists – 14 days for "clean" electronic claims, 30 days for other "clean" claims – by the Medicare-operated plan.