The Office of Inspector General ("OIG") Issues Report on the Effect of the Part D Coverage Gap on Medicare Beneficiaries without Financial Assistance in 2006

On March 4, 2009, the OIG issued a report on the effect of the Part D coverage gap on Medicare beneficiaries who did not receive financial assistance in 2006.  The OIG found that seven percent of Part D beneficiaries entered the coverage gap and did not receive financial assistance with prescription drug costs.  Of those who did not receive financial assistance during the gap, 98 percent made some type of change to their drug purchasing behavior.  Of the 98 percent, 69 percent of beneficiaries decreased the average number of drugs they purchased, and  38 percent of beneficiaries sought at least one less-costly alternative to purchasing drugs.  Twenty percent of those surveyed may have been eligible for a low-income subsidy, but did not enroll.  Additionally, one-third of those surveyed appeared to have compromised their drug regimens with changes in use.

The OIG recommended that CMS support outreach and educational programs targeted at beneficiaries who make more prescription drug purchases before entering the coverage gap.  CMS did not concur with this recommendation.  CMS believes current outreach is sufficient.  The OIG also recommended that CMS target low-income subsidy outreach to beneficiaries who entered the coverage gap without financial assistance.  CMS concurred with this recommendation.  For a full copy of report number 05-07-00610.