Category Medicare

Rx Choice: Last Chance to Be Heard Is Friday!

Susan Weinstein, JD
Editor in Chief, Care for Your Mind

This Friday, January 25, 2019, is the deadline for submitting your comments to help preserve access to the spectrum of drugs for treating health conditions like depression, schizophrenia, cancer, HIV, and epilepsy and supporting organ transplants for people on Medicare.

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Tell CMS: Preserve Medicare’s Six Protected Classes

Chuck Ingoglia
Chuck Ingoglia
Executive Director, Partnership for Part D Access

One of Medicare’s key patient protections – the six protected classes – is under threat by a new proposal from the Trump Administration. Feedback from the public will be critical in deciding whether or not they move forward — that’s why it’s essential that you let your voice be heard.

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Why the Six Protected Classes Should Be Protected

Susan Weinstein, JD
Editor in Chief, Care for Your Mind

The Trump Administration has proposed a new rule that would change Medicare Part D, removing the requirement that Part D prescription plans cover “all or substantially all” medications in six “protected” classes: anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals, and immunosuppressants. Why does this matter to us?

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Nursing Homes Are Turning Away Patients with Mental Health Issues

Daniel D. Sewell Photo

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Chemical restraint is a serious problem in nursing homes. History has shown that psychotropic medications tend to be overused in order to keep residents with problem behaviors such as wandering or combativeness subdued or “under control.”

In other words, there are documented instances when serious psychiatric drugs are given to people who might not have needed them.

To address this and other nursing home quality issues, the Centers for Medicare & Medicaid Services (CMS) created a Five-Star Quality Rating System. One of the rating criteria is the number of residents at the facility who are receiving antipsychotic medications: the larger the number, the lower the score the facility receives.

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Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression
Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

In older adults, depression can have severe consequences. It’s associated with an increased risk of suicide; decreased physical, cognitive and social functioning; and greater self-neglect; all of which are associated with increased mortality. This is a vulnerable population that needs effective, affordable access to mental health care.

Unfortunately, proposed changes to the Medicare Part D drug program would put older patients living with depression at even greater risk.

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Older Adults Are Being Overlooked When it Comes to Mental Health Care

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

For most individuals in the U.S., accessing mental health care is a struggle, but older adults may have it worst of all. Due to stigma, misinformation, and false beliefs about aging, they frequently go without adequate care for depression and other psychiatric illnesses and psychological problems. Too often, doctors offer prescription drugs as a cure-all solution, and fail to address the overall mental health and well-being of the older patient.

The truth is, addressing mental health issues in older populations requires paying more attention, not less. In aging adults, depressive symptoms can point to a physical illness, while physical pain or other physical complaints can often be a sign of mental health issues.

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Medicare Part D Users are Feeling the Squeeze

If concerns about being able to retain access to the correct medications to treat their mood disorders was not enough, individuals utilizing Medicare Part D must also be concerned about whether or not they can even afford to take their prescribed medications.

When Medicare Part D took effect in 2006, it arrived with mixed reviews. Today, according to a survey conducted by Medicare Today, 86% of seniors say they are satisfied with their prescription drug plan. One reason they site for the satisfaction is that the costs are reasonable. Given the way things are trending however, the Center for Medicaid and Medicare Services (CMS) may see satisfaction dip.

Cost related non-adherence to medication protocols is growing. The inability to pay for costly medicines causes patients to stretch out their prescriptions by skipping or taking smaller doses than prescribed. In in a recent Health Affairs study, (Medication Affordability Gains Following Medicare Part D Are Eroding Among Elderly with Multiple Chronic Conditions) seniors experiencing four or more chronic conditions reported a cost-related non-adherence rise from a low of 14.4% in 2009 to 17% in 2011.

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Speak Out About Potential Reductions to Medicare Part D Benefits

Last Tuesday, September 30, DBSA participant Trudy Lapin shared her story during two Congressional briefings sponsored by the Partnership for Part D Access. Trudy used her time to explain to Congressional staff from both the House and the Senate why a proposed regulation by CMS to restrict access to medication that aids in the treatment of mood disorders is misguided. You can read Trudy’s statement below, and learn how you can share your story with your own elected officials.

Treatment is not one size fits all
Although I was first diagnosed officially with major depression in 1993, signs of that particular mood disorder appeared in childhood. While attending college, an over achieving pattern went into high gear. I elected a double major in French and English literature with a minor in secondary education. I graduated with highest honors; accepted a full fellowship to Yale Graduate School to pursue my doctorate in Romance Languages and Literatures; taught French language, literature, and film at Yale College and at the University of Chicago; and was awarded a National Endowment for the Humanities grant, where I enjoyed the privilege of working with humanities scholars at Princeton University.

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