LCAO Principles for a Medicare Prescription Drug Benefit
In February 2000, the Leadership council of Aging Organizations (LCAO) forwarded a set of principles to the Congress and the Administration outlining the critical issues that must be addressed in any Medicare prescription drug benefit that will gain LCAO support. The LCAO continues to support these principles as essential elements that must be incorporated into any major legislation to expand seniors’ access to outpatient prescription drugs. Below are the LCAO principles:
Benefits
Medicare should guarantee access to a voluntary prescription drug benefit as a part of its defined benefit package.
Medicare’s prescription drug benefit should provide comprehensive coverage, including the most current, effective, and individually appropriate drug therapies.
Medicare's contribution toward the cost of the prescription drug benefit must keep pace with the increase in prescription drug costs and must not be tied to budgetary caps.
Adding a Medicare benefit must not reduce access to other Medicare benefits.
Coverage
The Medicare prescription drug benefit should be available to all Medicare eligible older Americans and persons with disabilities, regardless of income or health status.
The Medicare prescription drug benefit must be voluntary and provide safeguards against erosion of current prescription drug coverage provided by others.
Affordability
The financing of a new Medicare prescription drug benefit should protect all beneficiaries from burdensome out-of-pocket expenses and unaffordable cost sharing, particularly low-income beneficiaries.
The new benefit must protect individuals from extraordinary expenses for prescription drugs.
The government subsidy must be sufficient to guard against risk selection and to provide an attractive benefit design.
Sufficient subsidies should be provided for low-income beneficiaries to ensure that they have access to the benefit.
Administration
The new prescription drug benefit should be efficiently managed, include appropriate cost-containment, and reflect the purchasing power of the Medicare beneficiary pool.
Quality
The new Medicare prescription drug benefit must meet rigorous standards for quality of care, including appropriate monitoring and quality assurance activities.
The Medicare program should work to prevent the overuse, underused, and misuse of prescription drugs.