New Medicare Preventive Programs Announced

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WASHINGTON (Talon News) — At a press conference held Monday, Health and Human Services Secretary Tommy Thompson announced new preventive benefits that will now be covered by Medicare. Joining Secretary Thompson at the news conference were Centers for Medicare & Medicaid Services (CMS) Administrator Mark B. McClellan, M.D., Ph.D.; American Cancer Society CEO John Seffrin, Ph.D.; American Diabetes Association CEO Lynn Nicholas, FACHE; and the C.E.O. from the American Heart Association M. Cass Wheeler.

“For too long, Medicare only paid for benefits after you got sick. Now, Medicare will pay for benefits that will help seniors prevent the onset of disease before it becomes serious,” Sec. Thompson said. “Starting this year, seniors will have better and greater access to benefits to help keep them healthy and improve their quality of life.”

Starting January 1 of this year, Medicare recipients will be privy to three new programs made available to new beneficiaries. These include a one-time physical examination dubbed “Welcome to Medicare,” cardiovascular screening, and diabetes screening. These new programs are being offered only to those people who enroll in the healthcare plan after January 1, 2005.

Also announced at the news conference was a new collaborative effort between CMS, the American Cancer Society, the American Heart Association, and the American Diabetes Association to try to ensure that seniors are made aware of the new programs, and that they take advantage of the opportunities and benefits these programs present. The additional benefits were mandated in the Medicare expansion law signed in December, 2003 by President Bush.

The new programs will offer participants up to two free diabetes screenings per year, and one free cardiovascular screening every five years.

The “Welcome to Medicare” physical exam will be a one-time offering, must be acquired within six months of Medicare enrollment, and is the only one of the three new programs that is not free. The physical examination, available to all new Medicare Part B beneficiaries, will cost patients 20% of the total charge, once the patient’s annual Part B deductible is met. The deductible in 2005 is $110.00, which could potentially be met with the physical exam co-payment.

“Approximately half of all diabetes cases occur in people older than age 55. For seniors with diabetes, early access [to education and treatment are very critical],” according to Lynn Nicholas, CEO of the American Diabetes Association. “These new preventive benefits for people with Medicare will assist seniors greatly in meeting these needs.”

Speaking for the American Cancer Society, CEO Dr. John Seffrin said, “Medicare’s new emphasis on prevention and early detection marks a dramatic shift that will help us in the fight against cancer.” He also pointed out that the new physical exam will offer doctors not only the opportunity to refer patients for screenings, but also the chance to “counsel them about risk factors for cancer-tobacco use, diet, and physical activity.”

For his part, M. Cass Wheeler, CEO of the American Heart Association, praised Sec. Thompson for “bringing a renewed emphasis on prevention to the nation’s health priorities,” adding that the new programs will “go a long way to empowering beneficiaries to help keep themselves heart healthy and stroke free.”

Dr. Mark McClellan, CMS Administrator, asserted that, in the past, the majority of Medicare funding has been spent on treating illnesses after they occur.

“We are changing that now as we help seniors use preventive care,” McClellan said, adding that, coupling the new programs with the prescription drug coverage slated to take place next year, will help them “avoid many costly and debilitating problems.”

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