Medicare Congress: Overview

Overview

The Issue

The new Medicare prescription drug legislation constitutes the most important change to the Medicare program since its inception. The 2003 Act added a new Medicare drug benefit (Part D), offered by drug plans or Medicare Advantage plans. This benefit covers outpatient prescription drugs not previously covered by Medicare. It requires payment of an additional premium (the Part D premium) by the beneficiary, although the premium is subsidized by the federal government. Congress authorized $400 billion over a 10-year period to subsidize premiums. The benefit will not be available until 2006. In the meantime, HHS will review and endorse drug discount card programs that meet certain criteria. Both the discount card and Part D drug plan coverage provide for additional subsidies for eligible low income individuals.

The new legislation remains controversial. Many provisions of the legislation, particularly the doughnut hole in the benefit package and the prohibition of Medicare negotiating pharmaceutical prices directly, continue to provoke discord. It barely passed the House and passed the Senate by avoiding a filibuster. Support and opposition crossed traditional political lines. The legislation was carried by Republicans. The New York times was pro; the Wall Street Journal con. Many conservatives opposed the legislation. AARP supported it. Most astute political observers believe that additional legislative initiatives in coming years are inevitable.

The Medicare Congress seeks to explain the policy and political debate around the new legislation and to assess the tactical and strategic importance of the new law to the major participants in the health care marketplace, including both patent and generic pharmaceutical manufacturers, PBMs, SROs and CROs, pharmacies, pharmacists, health plans, third party administrators, health care providers and beneficiaries. The Congress will deal in depth with a number of technical issues, including the actuarial, regulatory and compliance and R&D implications of the legislation.

Written Materials

The Faculty of the Congress will prepare written materials to accompany their presentations, including copies of presentation overheads, slides and related materials that will be included with the Congress materials.

Sponsoring Publications

Harvard Health Policy Review, www.HHPR.org, published by Exploring Policy in Health Care at Harvard (EPIHC).
Heath Affairs, www.HealthAffairs.org, a bimonthly, peer-reviewed journal that explores health policy issues of current concern.
Health Leaders, www.HealthLeaders.com, a leading multi-platform media company addressing the information needs of healthcare executives and professionals.
Inquiry, www.InquiryJournal.org, seeks to improve the nation's health system by offering a forum to discuss health policy, innovation and original research.
Journal of Health Policy, Politics and Law, www.JHPPL.org, publishes research and analysis related to the intersection of health, public policy, politics, and law.
The Milbank Fund, www.Milbank.org, publishes the Milbank Quarterly and engages in nonpartisan analysis, study and research in health policy.

Who Should Attend:

Pharmaceutical Manufacturer, PBM and Pharmacy Executives and Board Members
Health Plan, Health System and Physician Organization Executives and Board Members
Medical Directors
Physicians
Pharmacists
Purchasers, including Private Employers and Public Purchasers
Pharmaceutical Manufacturers
Generic Pharmaceutical Manufacturers
Directors of Site Management Organizations
Directors of Clinical Research Organizations
Directors of Pharmacy Benefit Management Companies
Directors of Wholesale, Retail, Mail Order and Internet Pharmacies
Directors of Health Plans and Health Insurers
Third Party Administrators
Health Care Attorneys and In-house Counsel
Health Care Compliance Officers
Health Care Privacy Officers
Health Care Ethics Officers
Food and Drug Law Attorneys
Health Care Auditors
Health Care Actuaries
Directors of Government Programs
Director of Medicare Programs
Director of Regulatory Affairs
Director of Medicare Marketing
Director of Medicare Quality
Director of Medicare Compliance
Directors of Finance and Reimbursement
Pharmaceutical Consultants
Institutional Investors
Investment Bankers
Venture Capitalists
Health Care Regulators and Policy Makers
Health Services Researchers and Academics

The Congress Goals and Objectives

To Provide an Overview and Analysis of the New Medicare Prescription Drug Legislation
To Present the Inside Story of the Legislation's Development from the Perspective of House and Senate Staff and the Press
To Provide an Overview of the Legislation Implementation Process and Time Frame by CMS and FDA
To Set Forth the Potential Role, Opportunities and Responsibilities of Pharmaceutical Manufacturers, PBMs, Health Plans and Providers under the New Legislation
To Assess the Financial and Budgetary Realities and Long Term Health Policy Implications of the New Legislation
To Analyze the Implications of the New Legislation on Operational and Compliance Standards in the Pharmaceutical Industry
To Review Existing Discount Card Programs and Compare the New Prescription Drug Discount Card Program
To Describe the Impact of the New Medicare Prescription Drug Legislation on Pharmaceutical R&D Investments and Pricing
To Discuss the New Medicare Prescription Drug Legislation's Implications for the Pharmaceutical Sector's Financial Markets
To Relate ePrescribing Provisions of the New Medicare Law and How They will Change the Pharmaceutical Supply Chain
To Assess the Impact of the New Legislation on the States
To Articulate Product Development Strategies for Medicare+Choice and Medicare Advantage
To Analyze the Impact of Part B Reimbursement Reform on Private Insurance Payment and the Future of AWP-based Reimbursement
To Set Forth the Major Issues in the Drug Reimportatrion Debate
To Speculate Whether the Medicare 2010 Competition Demonstrations Will Ever Happen
To Assist Seniors Make Smart Prescription Drug Decisions under the New Medicare Prescription Drug Legislation