AARP Rhode Island calls on Congress to act on lowering high drug costs

Published on March 14, 2022 in Rhode Island News Today

On the day before the Washington, DC-based AARP’s March 8th launch of its new ad campaign showing the impact of Congress’s failure to act on prescription drug prices, AARP Rhode Island State Director Catherine Taylor, Volunteer State President Marcus Mitchell and Volunteer Lead Federal Liaison Dr. Phil Zarlengo joined Rhode Island US Senators Jack Reed and Sheldon Whitehouse for a virtual news conference highlighting the need for Congress to act now to slash rising prescription drug costs. 

During the 26 minute and 45 second event, AARP Rhode Island, representing 132,000 members, delivered a petition signed by more than 16,114 Rhode Islanders, calling for Congress to act now and stop unfair drug prices. AARP has called for fair drug prices for years and supports legislation that passed the House in November, which would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

“Americans are fed up with paying three times what people in other countries pay for the same drugs. More than four million people across the country, including more than 16,000 here in the Ocean State, are joining AARP to demand lower prices for prescription drugs,” said Taylor in a statement announcing the petition being delivered to Reed and Whitehouse. “There will never be a better time to lower drug prices than the historic opportunity in front of Congress. Now is the time to get it done!” Taylor says.

Big Pharma makes billions from high drug costs

“Big Pharma is making billions while seniors and taxpayers are suffering,” says AARP State President Mitchell, noting that just last month Big Pharma raised the prices of 800 prescription medications.” People are sick and tired of paying three times for prescription drugs what people in other countries are paying for these drugs, “It’s outrageous and unacceptable,” Mitchell said.

According to Mitchell, “if consumer prices had risen as fast as drug prices during the last 15 years, gas would cost $12.20 a gallon and milk would cost $13 a gallon.” This gives perspective to this issue, he said.

“Big Pharma is trying again to scare lawmakers and members of AARP and everyone else with misleading claims to stop Medicare to negotiate prices, charged Zarlengo. “We, at least, know the truth. The truth is by allowing Medicare negotiation [of prices], that process will help seniors during these times of inflation by lowing their prices of drugs and putting more money in their pocket,” he said.

Zarlengo gave the two Rhode Island Senators a message from Rhode Island seniors: “Don’t let Pharma win this time, lets lower drug prices now.”

“We hear you loud and clear,” said Senator Reed, responding to the over 16,000 signees of AARP’s petition. “Congress must address this issue of drug pricing. The system continues to force families into untenable choices between their health and other basic needs. One of the simplest things to do is to allow the federal government to negotiate drug prices for Medicare beneficiaries. I have been urging administrations, both Republican and Democratic for more than a decade to do this,” he noted.

“The VA already does this,” said Senator Whitehouse told his fellow panelists and those tuning in to the March 7 news conference. “And there is a big discrepancy in what the Veterans Administration (VA) pays for drugs and what Medicare pays for drugs. We have a reconciliation bill still in the Senate; it’s something Democrats can pass with only 50 votes. The bad news is that we need all 50 members to agree on the reconciliation measure and that has proven difficult. I hope we can agree on a package that all 50 of us can sign off on… and finally, finally, finally give Americans the drug pricing relief that they need. AARP is incredibly important in this fight. All your members make a difference. Thank you for stepping up yet again,” he said.

AARP fights Big Pharma on television and with digital advertising

In AARP’s new ad campaign, Larry Zarzecki, a retired law enforcement officer with Parkinson’s Disease who was forced to sell his home in order to afford his medications, returns to the airways as a spokesperson for AARP, illustrating the impact of the high cost of prescription drugs on seniors.  The retiree first shared his story in an AARP ad three years ago, but Congress’ failure to act means he has had no relief from the high cost of his treatments. As he says in the new ad, “I shouldn’t have to decide between my home or my medicine because Congress refuses to act. I’m tired of waiting for Congress.”

AARP’s seven-figure ad buy includes television and digital advertising in the DC area, and television in Arizona, Colorado, Georgia, New Hampshire, New York, Nevada, and Pennsylvania.

Responding to AARP’s new ad campaign, AARP Rhode Island’s Taylor said: “Larry Zarzecki was forced to sell his home in order to afford his medications.  He is but one example of Congress’ failure to act. No one should have to give up a home in order to pay for over-priced prescription medicines.  She called on Congress to put a stop to “spiraling price increases” by giving Medicare the authority to negotiate with pharmaceutical companies for lower prices.

“If the Veterans Administration can do so – paying roughly half as much for brand name prescription drugs as does Medicare Part D – then why can’t Medicare?” says Taylor.  “For a decade, Big Pharma has spent more on stock buybacks and dividends than on research and development; it’s outrageous that drug makers are charging Americans three times what people in other countries pay for the same drugs and justifying it with lies and scare tactics that simply don’t hold up,” she  added.

AARP has called for lower drug prices for years and is urging the Senate to pass legislation that would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

“Americans are sick and tired of Congress’ broken promises to bring down the price of prescription drugs,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer announcing the launching of this ad campaign. “As Americans pay more and more for many consumer goods, Congress has an historic opportunity to lower drug prices and help seniors like Larry to afford their medications and other essentials,” she said.

It’s time to act NOW

According to AARP, without congressional action, pharmaceutical companies will continue to set high prices for prescription drugs and raise them without any warning or justification. The Washington, DC based advocacy group representing 38 million members recently released a report showing that 75 of the 100 brand name drugs with the highest total Medicare Part D spending have already increased their  list prices in the first month of 2022.

During the State of the Union, President Biden called for Congress to bring down the price of prescription drugs as a way to help consumers manage rising prices. The House of Representatives passed several prescription drug measures as part of the Build Back Better Act in November, but the Senate has yet to pass similar legislation.

It’s time for the Senate to put the welfare of the nation’s seniors first by passing legislation to put the brakes to spiraling prescription drug costs. This will be a hot campaign issue in the upcoming mid-term elections, just 230 days from now.

Medicare slow to fix equity issue for seniors’ access to at-home COVID test kits

Published on Feb. 7 in Rhode Island News Today

Today home test kits were made available in a variety of ways – but, for Medicare recipients, it was a different story, being forced to go thru a different purchasing and payment process than those having private insurance, or no insurance. That process required the oldest and most at-risk population to take more than several steps, put up their own money, do a lot of paperwork, to seek reimbursement.

The White House made changes in testing so that at-home tests are now fully covered by health insurances. Those insured can pick up their test kits in a store and have them paid for at the time of purchase by their insurance, at no cost to the person. They aren’t required to visit their physician or get a prescription to obtain the free test. They have a limit of 8 test kits per month.

But, when the program began, this was not the plan for those insured through the government’s Medicare and Medicare Advantage plans.

Red Tape… Upfront Charges for COVID-1

Jane, a 65-year old Medicare beneficiary from Warwick went through the steps to get a kit after a relative she had seen found out she was exposed to COVID.  Before Medicare announced easing up on the purchasing process of COVID-19 test kits, she expressed frustrations to this writer about the regulatory hoops she faced because she was on Medicare – purchasing the test kits and getting reimbursed for the upfront charges. “First, I had to request a prescription from my physician and say that I had either been exposed to someone who had COVID, or I was having symptoms, myself,” recalls the frustrated Medicare beneficiary.  “Once my physician sent the prescription over to CVS, I was notified that it would take a couple of days before I could pick up the kits and that I would only be given two kits per prescription”, she fumed, knowing that sometimes it takes 4 or 5 days of testing to test positive, but was only eligible to receive two, and she might have to go through the whole process again in a few days.

“Three days later CVS finally left me a message saying these kits were in. I used the drive-up window for pickup and the cashier asked me for $46,” Jane remembered.  “When questioning this charge, a pharmacist came to the window to assist and told me that I had to pay for the kits upfront and then seek reimbursement,” she added.

Paying for the kits, Jane went home, and called Blue Cross, her Medicare supplement company and was told she needed to request a copy of the prescription which took hours to finally request with the back and forth phone calls to her busy doctor’s office. It was almost two weeks later she finally got a copy of the receipt detailing her $46 payment for the kits. She was then able to upload the copy of the prescription and a copy of her receipt to a BCBS reimbursement screen on her computer (or she could have printed the form out and mailed the whole package in). At press time, Jane is still waiting for her reimbursement, being told it will take from 4 to 6 weeks to receive a check.

It’s better late than never, says Jane, when she heard that Medicare would now cover free over-the-counter COVID-19 tests. “Not everyone can put out $46 and wait two months to get it back, home health tests were made available in a variety of ways – but, for Medicare recipients, there was a different process. More concerning was all the steps I had to take to complete the process they had originally intended for us to do. How many people would really complete all those steps?” she says. “We talk a lot about equity, but seniors need equitable healthcare processes, too.”

Just days ago, the Centers for Medicare & Medicaid Services (CMS) announced that beneficiaries in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring, estimated to be in April. Under the new CMS initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA). A prescription will not be required.

CMS Unveils New Medicare Benefit

According to CMS, this new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost. This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries.

CMS’s announcement follows last month’s announcement that the Biden-Harris Administration would be requiring commercial health insurance companies to cover at-home COVID tests for free.

Until the new benefit kicks in, Medicare beneficiaries can access free tests through a number of channels established by CMS, too. Now, they can request four free over-the-counter tests for home delivery at covidtests.gov. Or beneficiaries can access COVID-19 tests through health care providers at over 20,000 free testing sites nationwide. Many cities and towns are also giving out free test kits at drive-up handout programs as the state receives supplies.

CMS’s Feb. 3 statement noted that Medicare beneficiaries can also access lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost. In addition to accessing a COVID-19 lab test ordered by a health care professional, people with Medicare can also already access one lab-performed test without an order, also without cost sharing, during the public health emergency, says CMS.

In addition, CMS says that Medicare Advantage plans may offer coverage and payment for over-the-counter COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and Part B benefits. Medicare beneficiaries covered by Medicare Advantage should check with their plan to see if it includes such a benefit.

Finally, all Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.

“AARP applauds today’s announcement that will guarantee access to at-home over-the-counter COVID-19 tests at no cost for Medicare’s 64 million beneficiaries and we thank [Health and Human Resources]Secretary Becerra and CMS Administrator Brooks-LaSure for their diligence in addressing this issue. Expanded access to no-cost testing will help protect seniors who have been hit hardest by the pandemic and ensure they can remain connected with their loved ones and community.,” says AARP Executive vice president and Chief Advocacy and Engagement Officer Nancy LeaMond in a statement issued with CMS’s Feb. 3rd announcement of the new Medicare benefit.

“Every American should have an easy way to get at-home COVID tests. We know that people 65 and older are at much greater risk of serious illness and death from this disease – they need equal access to tools that can help keep them safe. The cost of paying for tests and the time needed to find free testing options are barriers that could discourage Medicare beneficiaries from getting tested, leading to greater social isolation and continued spread of the virus, adds LeaMond.

Successfully Advocating the Seniors

Last month, Senators Sherrod Brown (D-OH) and Debbie Stabenow (D-MI) along with 17 of their  Senate colleagues including Rhode Island Democratic Senators Reed and Sheldon Whitehouse wrote to HHS Secretary Becerra and  CMS Administrator Brooks-LaSure urging them to expand Medicare coverage of free at-home rapid COVID-19 testing.

Aging groups also joined the Senators in pushing Medicare to offer the new testing kick benefit.  “It is clear that regular testing is a crucial part of managing the spread of COVID-19. That’s why AARP has been calling for coverage of at-home tests, says AARP’s LeaMond, noting that the nation’s largest aging advocacy group “will continue to watch for details about when and how at-home COVID tests are made available to those in Medicare.”

Thankfully CMS quickly heeded their calls.

For more information, please see these Frequently Asked Questions, https://www.cms.gov/files/document/covid-19-over-counter-otc-tests-medicare-frequently-asked-questions.pdf (PDF)

Stay tuned for free N95 masks to be made available to all coming up soon.

Social Security learns from remote experience, plans field office openings

Published on December 13, 2021 in RINewsToday

On March 17, 2020, as the COVID-19 pandemic rapidly spread throughout the nation, the Social Security Administration  (SSA) issued a press release announcing that its offices would only offer phone service and online services.

However, in-person appointments at SSA were scheduled for critical issues, specifically for those who were without food, medicine, shelter, or those needing to apply for benefits or to reinstate them. This decision allowed SSA to provide critical services while protecting its employees and older beneficiaries, many with underlying medial conditions. 

Congress Expresses Concern Over Closing of SSA Field Offices  

Almost four months later, House Ways and Means Social Security Subcommittee chairperson John B. Larson (D-CT) and Republican Leader Tom Reed (R-NY) sent two letters to the SSA Inspector General Gail S. Ennis asking for a review of SSA’s telephone service during the COVID-19 pandemic and SSA’s process for obtaining medical evidence for disability claims.

The correspondence to SSA’s Office of Inspector General (OIG) noted that as the COVID-19 pandemic continues, beneficiaries are relying on their Social Security now more than ever. Except in dire need, beneficiaries are unable to access in-person services and are relying instead on telephone services.

Members of Congress warned that beneficiaries, especially those from vulnerable populations who lack internet connection especially in rural areas or don’t have a reliable phone number or mailing addresses, are struggling to gain access SSA while field offices are closed.

“As highlighted in the OIG’s recent report, even before the current crisis the pubic relied heavily in SSA’s telephone services, but often could not access timely information or assistance. In fiscal year 2019, SSA’s national 1-800 number and field  offices received over 143 million calls – but handled fewer than to 3 of these calls. Callers who did not get a busy signal or give up while on hold waited to speak with an SSA employee for an average of 20 minutes on the 1-800 number and three minutes at field offices.

In addition, SSA requests millions of medical records each year from health care facilities and health professionals across the country to obtain evidence of an individual’s medical condition. The medical records request is an important part of the disability process, but the most recent report on this topic from the OIG is from 2001 and does not reflect changes to the process over the past nearly 20 years.

“Social Security benefits are earned by hard-working Americans, and we must do everything we can to ensure people are receiving the quality customer service they deserve.  These reports will provide important information to make sure Americans are receiving the service they expect and deserve from SSA,” said Larson and Reed.

SSA Responds to the Closing of Field Offices 

Almost two weeks ago, Ennis released a 58-page Congressional Response report, “The Social Security Telephone Service Performance,” detailing the impact on the closing of about 1,300 field offices.

The OIG found that in FY 2020, SSA received over 150 million calls, more than any other federal agency surveyed, and handled over half of those calls. Calls to field offices increased dramatically, from an average of 4.6 million calls per month leading up to the COVID-19 pandemic to an average of 7.5 million calls per month from April to Sept. 2020.

According to the OIG’s report, SSA’s telephone services shifted to more calls to field offices in FY 2020 when the agency closed its offices and provided the public with more field office telephone numbers. The increase in field office calls resulted in increased busy messages and wait-times toward the end of FY 2020. During the pandemic, SSA adjusted national 800 number operations to reduce wait times and the number of callers who received a busy message. National 800 number performance began to decline toward the end of the fiscal year, though it was still better then pre-pandemic performance.

When comparing SSA to 13 customer service call centers from 10 other federal agencies, SSA had a higher call volume in FY 2020 with similar or better performance.

To reduce wait times, improve caller experience, and ensure more calls are handled SSA hired additional 800-number staff, modified automated service options, and plans to implement a new telephone system.

“This [IOG] report highlights that SSA’s telephone services are vital to the American public. While I applaud the hard work of SSA employees, especially during the pandemic, the report also highlights actions that SSA is taking to reduce telephone wait times, handle more calls and improve caller experience, said Larson, noting that SSA will need more funding to do so and that is why he is supporting House Appropriations and Chair DeLauro’s proposal to give SSA an additional $1.1 billion in FY 2022.

Adds Reed, “This report provides clear evidence that with determined agency leadership and the hard work of dedicated staff, the SSA was able to respond to the largest management crisis in its history. With the almost 65 percent increase in phone calls during the pandemic the report also demonstrates the public’s clear and continued demand for access to the SSA’s vital services.” 

Opening the Doors

According to newly released 19-page SSA reentry plan, after more than 18 months working from home, senior SSA leadership are beginning to return to their offices, in early December. Employees are scheduled to return to their desks by Jan. 3. Along with in-person appointments, the agency will now also embrace telework. 

The agency will lift its current “work from home by quarantine” policy starting Jan. 2, at which point related collective bargaining agreements and pandemic policies will end as well. Reentry dates could change with the spread of the delta and omicron variant.

“We will use the evaluation period to develop, assess, and, if necessary, adjust any personnel or operational policies to provide public service and accomplish our mission as well as or better than, before the pandemic,” the SSA reentry plan reads. “Each [deputy commissioner] will evaluate their operations to identify ways to improve service, hire and retain the best employees and to operate efficiently including the consideration of potential space savings resulting from increased telework and information technology improvements.”

Over the next six months, the agency will review metrics on customer satisfaction, employee experience, service availability, workload, and environmental considerations.

“Throughout the pandemic, Social Security has helped many people through in-person appointments for certain situations in local offices nationwide and through options like online, telephone and video service,” Nicole Tiggemann, an SSA spokeswoman, said in an email to AARP, reported by Writer John Waggoner in his Nov. 11 blog posting, “Social Security Takes Steps to Reopen Field Offices.

“We know that those options do not work for everyone, says Tiggemann. “In order to improve service, especially for people who have had difficulty reaching us during the pandemic, Social Security will begin implementing the reentry process agencywide as soon as possible, including taking steps to increase in-person accessibility,” she said.

AARP applauds a return to normalcy at SSA. “Obviously, from our point of view, we’d like to see those offices open and staffed as soon as possible,” says Joel Eskovitz, director of Social Security and Savings at the AARP Public Policy Institute,” in Waggoner’s blog posting.