Dispute Develops Over Medicare Rebate Policy

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(Host) There’s a dispute between the Douglas administration and Senators Patrick Leahy and Bernie Sanders.

It’s over the fate of rebate checks that are being sent to senior citizens to help offset the cost of prescription drugs.

The Douglas Administration says the rebates should go to the state. But Leahy and Sanders say seniors should keep the money.

VPR’s Bob Kinzel reports.

(Kinzel) It’s not often that Vermont’s congressional delegation and the Governor’s office voice their policy disagreements in public but it’s happening now with these rebate checks.

As part of the new federal health care law, $250 rebate checks are being sent to senior citizens to cover a gap in the Medicare Prescription drug program. It’s a gap known as "the donut hole." 

Here’s how it works. Medicare pays roughly the first $3,000 of an individual’s drug expenses. Then for the next $3,000 individuals are responsible for all the costs.  Coverage kicks in again when a person exceeds roughly $6,000 in drug bills.

Those rebate checks are now being delivered to seniors in Vermont. But there’s the problem – the Douglas Administration wants the money because Vermont is one of the few states that has a program in place to cover donut hole expenses for low and moderate income seniors.

So the Administration thinks the seniors are getting a double benefit in this case – state coverage and a rebate check.

Susan Besio is the director of the Office of Vermont Health Access.  She says the state needs the rebate money to help finance its drug assistance program and she thinks Leahy and Sanders are a little confused:

(Besio) "We think that the congressional delegation doesn’t fully understand our VPHARM program…and we don’t think that people would want taxpayers to pay for these folks to both get the $250 rebate check and to also at the state’s expense have those claims covered for them."

(Kinzel) David Reville is a spokesperson for AARP Vermont. He thinks the state is wrong to try to recoup this rebate money from senior citizens:

(Reville) "The law is very clear on this $250 dollar donut hole check and we’ve got thousands of Vermonters who really can not afford drugs. Prescription drugs are very expensive and the law is clear that this money is to go directly to the beneficiaries and we don’t think it’s right for the state to be trying to take that money back."

(Kinzel) In a joint press release, Leahy and Sanders urged the Douglas Administration to reconsider its plan because "Vermont seniors who are struggling enough already to pay for the medicine they need can use all the help they can get."

For VPR News, I’m Bob Kinzel in Montpelier.

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