CMS Wants To Deny Prescription Coverage

CMS or the (Centers for medicare and Medicaid) want to stop prescription drug abuse but the method they have chosen to do so may hurt patients who really need the medicine. Their proposal would allow medicare to deny Medicare Part D medication coverage to people they suspect of prescription abuse.

The AMA is worried that this is going to cause problems for people who are really in need of medical treatment. "Physicians, not health insurers, have the expertise to make decisions about which medications a patient should receive," AMA President Peter W. Carmel, MD, said in a news release. "Medicare patients who are seriously ill or in severe pain should not be unjustly denied the medications prescribed by their physician." The AMA agrees that misusing prescriptions is a serious problem but that CMS is not qualified to make the decision if someone is abusing their prescriptions or not.

The AMA offers a solution that drug plans provide claim information to physicians. They believe in a real-time prescription information for doctors and increased funds for drug-monitoring programs.