Bill Would Cover Anti-Anxiety Drugs

WASHINGTON — Lawmakers said Friday they would seek to add to Medicare’s prescription drug benefit a category of drugs commonly used to treat anxiety, insomnia and seizures.

The benefit, which begins Jan. 1, currently excludes coverage of a category of drugs called benzodiazepines. But mental health experts say that "benzos" are sometimes the most appropriate drugs for patients, and that a sudden switch to other drugs can be life-threatening.

Xanax, Valium, and Ativan are among the most widely used benzos.

"This glitch in the Medicare law threatens the health of our beneficiaries," said Rep. Benjamin Cardin, D-Md., who is sponsoring the bill to strike the exclusion, along with Rep. Jim Ramstad, R-Minn. "The administration recognizes the problem, but it does not have the authority to fix it. Congress does, and I hope that we can pass this bill soon."

The Associated Press reported last week that the drugs were being excluded from the prescription drug benefit, prompting Cardin to take action.

Today, all states provide some Medicaid coverage for benzodiazepines, and about 1.7 million low-income senior citizens take the drugs. However, those senior citizens are supposed to get their prescription drug coverage through Medicare once the program kicks in Jan. 1. If the exclusion stands, states could decide to eliminate coverage.

Many beneficiaries who are not Medicaid-eligible will be forced to pay out-of-pocket costs for their medicine, or pay for extra coverage through additional premiums.

Most states have restrictions on their coverage of benzos because the drugs are highly addictive and often used inappropriately. Most are on the Beers’ List, a guide that identifies medications that should be avoided by the elderly, said Dennis Smith, director of the federal Center for Medicaid and State Operations.

But Smith urged states to continue coverage for those patients where the drugs are considered medically necessary.

"The blanket exclusion of benzodiazepines from coverage under the (Medicare) program could have serious negative consequences to the physical and mental health of millions of elderly and disabled Medicare beneficiaries, and inappropriately limit physicians’ ability to develop the most appropriate prescription drug program for their patients," said Michael Maves, executive vice president and CEO of the American Medical Association.

Groups supporting the Cardin bill include the AMA, the American Psychiatric Association and the National Alliance for the Mentally Ill.