GAO: Medicare HMOs skimp on drugs - Brief Article

Some Medicare HMOs are playing fast and loose with their prescription outpatient benefit. William Scanlon, director of health financing and systems issues for the General Accounting Office, told the Senate Select Committee on Aging that a survey of 16 Medicare HMOs turned up "serious problems with plan information regarding coverage for outpatient prescription drugs, a benefit that attracts many beneficiaries to Medicare managed care plans." One HMO promised in its contract with Medicare that it would provide name-brand drug coverage of at least $1,200 a year. However, that plan's membership literature advertised drug coverage that was less generous, as low as $600 a year, in a number of areas. Other plans promised Medicare they would cover nonformulary drugs, but refused to do so when patients requested those drugs.

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