Anger builds over Medicare drug limits

Dozens of lawmakers from both parties pleaded with federal health officials Wednesday to drop their proposed changes to Medicare drug coverage.

The latest bipartisan letter to the administration reflects almost unanimous opposition to a proposal that would allow insurers to limit coverage for certain types of drugs in Part D.

Both Republicans and Democrats argue that the changes, motivated by cost concerns, would directly harm patients and undermine the success of Medicare's drug program.

"We are extremely troubled by the proposed rule," lawmakers from the House Energy and Commerce, and Ways and Means committees wrote Wednesday.

"This proposed policy will place harmful limits on Medicare beneficiaries' access to necessary medications … [and] will inextricably tie the hands of physicians who treat these individuals."

At stake in the fight are three classes of drugs that currently have "protected status" in Medicare: immunosuppressants, antidepressants and antipsychotic medications.

Regulations proposed earlier this year would remove those special designations, allowing insurers to limit the number of drugs they cover in each of the three classes.

Three other types of drugs — cancer, HIV and anti-seizure meds — would retain protected status under Medicare.

The proposal has received opposition from nearly all quarters, including insurers, healthcare providers, patient advocates and Capitol Hill.

The administration argues, however, that narrowing protected status for some drugs will lower unnecessary healthcare costs and tamp down on overprescribing.

Federal health officials have pointed to studies finding that the six protected classes make up a substantial portion of all drug spending in Medicare Part D.

"CMS proposed for public input a number of policies to protect the integrity of the Medicare program while lowering costs, improving care quality and enhancing protections for Medicare beneficiaries," said a spokesperson for the Centers for Medicare and Medicaid Services (CMS).

"CMS will listen carefully to the comments from all stakeholders, including members of Congress, prior to finalizing any proposal."

Wednesday's letter from roughly 50 lawmakers followed a similar entreaty by the Senate Finance Committee and another by a coalition of more than 200 healthcare industry players and groups.

The regulations are open for public comment until March 7.

—This post was updated at 12 p.m. with the statement from CMS.