A new type of asthma therapy might be especially helpful for people with severe asthma who often have to take oral steroids to control their symptoms.

The drug is called mepolizumab, and two small studies in the March 5 issue of the New England Journal of Medicine have found that, when taken regularly, it can reduce asthma exacerbations. Additionally, people taking the drug had lower levels of eosinophils, a type of white blood cell that has been implicated as a potential cause of asthma.

“This is a new treatment which substantially reduces the risk of asthma attacks in a severe asthma population,” said the senior author of one of the studies, Dr. Ian Pavord, a consultant physician and an honorary professor of medicine at Glenfield Hospital, University Hospitals of Leicester, England.

Dr. Paul O’Byrne, the senior author of the other study, added that “we now have a likely new treatment modality that will improve outcomes and reduce exacerbations in severe prednisone-dependent asthma, and this is not a small population — it’s probably 2 to 4 percent of the asthmatic population.” O’Byrne is chairman of the Department of Medicine at McMaster University and executive director of the Firestone Institute for Respiratory Health at St. Joseph’s Hospital in Hamilton, Ontario, Canada.

Both studies were funded by GlaxcoSmithKline, the pharmaceutical company that is developing the drug.

He said that mepolizumab works by blocking a protein called interleukin-5, which is essential for the development of eosinophils. Eosinophils have long been implicated in asthma, though their exact role remains unclear. However, scientists do know that when an asthma exacerbation occurs, eosinophil levels usually rise.

In the first study, Pavord and his colleagues randomly placed 61 people with severe asthma on either 750 milligrams of mepolizumab or a placebo for a year. The drug and placebo were administered intravenously once a month for a year.

Over the study period, those on mepolizumab had fewer asthma exacerbations than those on placebo — 2 versus 3.4. People taking the drug also reported a greater improvement in their quality of life than did people taking the placebo.

The second study was smaller, including just 20 patients. Nine received 750 mg of mepolizumab, and 11 were given a placebo. Again, the drug and placebo were administered in intravenous doses once a month.

Everyone in this study had severe, prednisone-dependent asthma. Prednisone is an oral steroid that is generally quite effective in treating asthma but has numerous and serious side effects.

In the six-month trial, there were 12 asthma exacerbations in 10 people on placebo. Nine had evidence of eosinophils during their exacerbations. During the study, just one person in the treatment group had an exacerbation, but no eosinophils were present. Additionally, those taking the drug were able to reduce their dosage of prednisone more than people on placebo could.

Mepolizumab was not associated with a serious side effect in either study, though both authors pointed out that the studies were small and no more than six months to a year long.

“If you are one of those people [who has eosinophils] and your asthma is pretty severe, this may be a relatively promising treatment to prevent exacerbations, though it’s still experimental,” said the author of an accompanying editorial in the same issue of the journal, Dr. Sally Wenzel, director of the Asthma and Allergy Center at the University of Pittsburgh Medical Center.

But, she pointed out that not everyone who has asthma also has eosinophils.

All three experts said they were not sure if mepolizumab would have a place in treating less severe asthma, at least for awhile. O’Byrne said that the drug needs to be studied in larger populations and it’s currently very expensive, which would limit its use by people who have other treatment options.

In a long-awaited legal decision, the U.S. Supreme Court ruled Wednesday that patients who are injured by a drug can sue the drug’s manufacturer for damages, even if the drug has been granted FDA approval.

The decision, in the lawsuit Wyeth v. Levine, upheld $6.7 million in damages to a Vermont musician named Diana Levine who had to have her arm amputated after Wyeth’s Phenergan anti-nausea drug hit an artery and caused gangrene.

The complication is a rare one but is acknowledged on the drug’s labeling. Wyeth had argued that the U.S. Food and Drug Administration warning carried on the drug was sufficient.

At a press conference after the decision was announced, Levine, who was injured in April 2000, said: “I’m on the ceiling, I’m just so high about this, I’m so glad, it’s such a good decision and, next to getting my hand, it’s the best they could do, and it’s the least they could do. I’m in a state of almost shock and almost unrestrained joy.”

The court decision was hailed as a triumph by Public Citizen, a consumer watchdog group.

“It’s a terrific decision, because it understands both the importance of compensation for people who are harmed by defective or mislabeled drugs and also understands that the tort system is a complement to the federal regulatory system, that it is not an obstacle to that system,” said Brian Wolfman, director of the litigation group at Public Citizen in Washington, D.C.

Wolfman served as one of Levine’s attorneys.

Bert Rein, an attorney for Wyeth, said the company “fully complied with federal law” in its labeling, and that the FDA “is in the best position to weigh the risks and benefits of a medicine,” The New York Times reported.

In a news release, the Pharmaceutical Research and Manufacturers of America (PhRMA), said the group “is still reviewing the various opinions in the Wyeth v. Levine case. We continue to believe that the expert scientists and medical professionals at the Food and Drug Administration are in the best position to evaluate voluminous information about a medicine’s benefits and risks and to determine which safety information to include in the drug label.”

The high court’s decision is likely to unleash a torrent of similar lawsuits around the country.

“The court opinion not only declined to tell pharmaceutical companies that they could have this kind of immunity, it, in fact, pushed somewhat in the other direction,” said Benjamin C. Zipursky, professor of law at Fordham Law School in New York City and visiting professor at Harvard Law School in Boston.

“Some trial lawyers who had been hesitant to bring claims against pharmaceutical companies are now going to be more willing to do so,” Zipursky said. “A number of cases that were stayed in state and federal court pending this decision will now go forward and go forward with a more plaintiff-oriented posture. This is going to change the balance of incentives for lawyers who are thinking about suing pharmaceutical companies to make them more willing to sue and make trial judges and appellate courts less willing to throw out weak cases.”

Wolfman added: “In general, it’s going to mean that these claims are not pre-empted and that people with drug and injury claims are going to be able to sue for damages and get to a jury and, if the jury agrees, be compensated for that.”

The high court’s 6-3 decision essentially upended moves by the Bush administration to protect drug makers from lawsuits as long as the product was FDA-approved.

Many watchers had predicted that the court would decide the other way, Zipursky said.

“It was a surprise in two respects,” he said. People had believed “that whatever the court did, it would rule narrowly and, in fact, the decision is quite broad.”

Many middle-age and older Americans aren’t getting enough micronutrients such as calcium, magnesium, potassium and vitamin C, all of which play an important role in maintaining health, a new study finds.

Researchers analyzed data from more than 6,200 people in four ethnic groups — white, black, Hispanic and Chinese. More than half of the participants took supplements, and those most likely to use supplements were older, women, white and college-educated. The most common supplements were calcium and vitamin C.

Dietary intake of calcium, magnesium, potassium and vitamin C was similar between those who took supplements and those who didn’t, but there were differences in median dietary intake levels between the different ethnic groups. Chinese Americans tended to have the lowest dietary intakes of all micronutrients, particularly calcium. Blacks also had significantly lower dietary intakes of calcium than whites and Hispanics.

The researchers also evaluated differences between high-dose supplements and multivitamins. High-dose calcium was associated with users meeting recommended daily allowances (RDA) or adequate intake (AI) for all ethnic groups.

However, some high-dose supplements could cause users to exceed their Tolerable Upper Intake Levels (ULs). For calcium, 15 percent of high-dose users exceeded the UL compared with 1.9 percent of multivitamin users and 2.1 percent of non-users. For magnesium, 35.3 percent of high-dose supplement users exceeded the UL, compared with zero percent of both multivitamin users and non-users. For vitamin C, 6.6 percent of high-dose users exceeded the UL, compared with zero percent of both multivitamin users and non-users.

The researchers also found that potassium intake was well below the RDA in both supplement users and non-users. This suggests it may be necessary to reformulate supplements to deliver higher potassium doses, they said.

“The present study indicates a clear association between meeting RDA/AIs and supplement use for calcium, magnesium and vitamin C,” wrote Pamela J. Schreiner, professor and director of graduate studies in the division of epidemiology and community health at the University of Minnesota, and her colleagues.

“However, even with the assistance of dietary supplements, many middle-aged and older Americans are not getting adequate nutrition, and there was no association between supplement use and meeting the AI for potassium,” the researchers concluded. “In addition, those taking high-dose vitamin supplements were more likely to exceed the UL for that nutrient. Future studies should explore dietary supplementation along with other methods to improve nutrition in middle-aged and older Americans.”

The study was published in the March issue of the Journal of the American Dietetic Association.

Despite some improvements, U.S. school meal programs are still laden with unhealthy fat, salt and sugar, nutrition experts contend.

Students also have limited choices in foods available in vending machines, á la carte in cafeterias, at school stores and snack bars and for fund-raisers, they say in a series of articles in a supplement to the February issue of the Journal of the American Dietetic Association.

Echoing these sentiments, a Chicago chef brought to the White House to cook for the Obamas has said that too much of the food available at schools also is high in additives and preservatives.

Unhealthy eating at school, these food experts believe, is contributing to the surge in obesity rates among U.S. children. Obesity rates have more than doubled among infants and toddlers aged 2 to 5, quadrupled in children aged 6 to 11 and more than tripled among adolescents aged 12 to 19, according to an editorial in the journal.

The rising rates have health experts concerned about a nascent epidemic of obesity-related diseases, including cardiovascular disease and type 2 diabetes, in young people.

“Of course, school meals are only one part of the problem,” said Anne R. Gordon, a senior researcher at Mathematica Policy Research in Princeton, N.J., and co-author of a paper on school lunches in the supplement. “Kids don’t eat well throughout the day. But, we do find at least some evidence that in some of the schools that restrict the availability of sugar-sweetened beverages, you don’t see the kids going and drinking more sugar-sweetened at other times of day. It really does decrease intake, so that’s encouraging.”

Gordon’s paper described and assessed data from the third School Nutrition Dietary Assessment, sponsored by the U.S. Department of Agriculture and conducted by Mathematica, as well as findings from other studies that used the same data. The USDA-backed analysis covered both the National School Lunch Program, which provides subsidized meals to about 30 million children daily, and the School Breakfast Program, which provides meals to about 10 million children a day.

The lunch program began in 1946 to help ensure that U.S. children were receiving enough nutritious food. The breakfast program was institutionalized in 1975. Both offer free or low-cost meals to eligible students.

“It’s very clear that USDA needs to update the standards of schools” related to nutrition, Gordon said. “They know what they’re aiming for, but … having standards is not enough.”

“We need to explore other ways of making change, which could include items such as providing more training and technical assistance to schools, providing more funding for nutrition education,” she said. “It also may be worth considering more laws or regulations to limit the availability of certain types of food, such as whole or 2 percent milk.”

Mary Ford, a registered dietitian and professor in the School of Public Health at the University of Minnesota, and author of the journal editorial, urged such action.

“Schools need to do even more to reduce the availability of high-calorie, low-nutrient foods and make school meals more nutritious,” she wrote. Foods available by choice to students — in vending machines, á la carte and the like — “should include only fruits, vegetables, whole grains and non-fat and low-fat dairy products,” she wrote.

The editorial also suggested that the federal government withhold funding for meal programs from school systems that don’t comply with stepped-up nutrition expectations.

Sam Kass, the chef who followed the Obamas to the White House, also has put the school lunch program under fire. According to a report in The New York Times in January, Cass attributes the nutritional shortcomings in school lunches, at least in part, to the use of donated surplus agricultural commodities that result from government subsidies.

“As a result, he says, meals served to students are low in vegetables and disproportionately high in fat, additives, preservatives and high-fructose corn syrup,” the Times report said.

The School Nutrition Dietary Assessment included information from 398 public schools in 130 districts across the United States, including 2,314 students in first through 12th grade during the 2004-05 school year.

It found that more than 70 percent of the schools served meals that met the standards for critical nutrients such as protein, vitamins A and C, calcium and iron.

But a mere 6 to 7 percent of subsidized meals met all nutritional standards, the study found. Most had too much saturated fat or fat overall, and not enough calories.

About 42 percent of the schools surveyed offered no fresh fruits or raw vegetables in their lunch programs.

Fat tended to come from salad dressings, condiments and spreads, pizza products, peanut butter sandwiches and french fries. Saturated fat tended to come from pizza products, condiments and spreads, 2-percent milk, salad plates or salad bars and hamburgers or cheeseburgers.

Foods in vending machines and offered á la carte and in snack bars were most often high in calories and low in nutrients: candy, french fries, donuts, sweetened drinks and salty snacks.

The study found that low-income children fared worse, nutritionally, than those from higher-income homes, although school-lunch-program participants generally got more nutrients in their meals than kids responsible for their own lunches.

As for remedies, Gordon and the other researchers offered some. “Innovative preparation methods or improvements in the presentation of fruits and vegetables could make these items more appealing to children,” they wrote. The study suggested that school cooks use whole-grain flours to prepare pizza crusts and mix whole-grain and regular pasta in pasta-based entrees and that school lunchrooms control the available portions of condiments such as ketchup, mustard and barbeque sauce to control sodium intake.

Gordon noted that schools have made progress in improving meal offerings, but more needs to be done.

“Part of it is getting kids to eat healthier foods, part of it is providing schools with more support,” she said.

Women who do not have enough vitamin B12 in their blood before and after conception have a greater chance of having a baby with brain or spinal cord defects, a new study says.

Most at risk may be vegans and vegetarians, since B12 is far more common in meat and animal-based foods, noted an American and Irish research team whose findings were published in the March issue of Pediatrics..

According to the study, women with low levels of B12 had at least 2.5 times the risk of giving birth to a child with these neural tube defects, which can lead to partial paralysis or even death, than women with the highest B12 levels.

“Vitamin B12 is essential for the functioning of the nervous system and for the production of red blood cells,” Dr. Duane Alexander, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in a news release issued by its parent organization, the U.S. National Institutes of Health. “The results of this study suggest that women with low levels of B12 not only may risk health problems of their own, but also may increase the chance that their children may be born with a serious birth defect.”

Researchers analyzed blood collected during the early pregnancy stages of hundreds of women from Ireland, a country with a high rate of neural tube defects. Either the women had previously given birth to a baby with a neural tube defect or were known to be carrying babies with the disorder.

Women with B12 concentrations below 250 ng/L before pregnancy had roughly three times the risk of having a child with a neural tube defect as those with higher B12 blood levels. Those women whose levels were less than 150 ng/L, which is considered B12 deficient, had five times the risk of women with higher levels.

The researchers used statistical techniques to focus solely on B12 levels and factor out the role of folic acid, a nutrient known to help prevent pregnant women from birthing babies with neural tube defects. The study authors noted that B12 and folate are jointly linked to several key biochemical reactions, but that a lack of either B12 or folate increased the risk of a neural tube defect.

While confirmation from other studies is needed, the authors suggested women should have vitamin B12 levels above 300 ng/L before becoming pregnant. Study co-author Dr. James L. Mills, a senior investigator in the NICHD division of epidemiology, statistics and prevention research, went further, recommending all women of childbearing age always consume the daily recommended amount of vitamin B12 and at least 400 micrograms of folic acid.

Medicare beneficiaries with limited income and resources, and those who are dually eligible for both Medicare and Medicaid, may qualify for extra help paying for their Part D premium and cost-sharing through the low-income subsidy (LIS), provided by Medicare.

Premiums for Medicare prescription drug coverage are based on prescription drug plan bids projecting the cost for providing coverage for the following year, costs that can change from year to year. Based on the bids, as required by law, CMS calculates the amount of the premium that will be paid for by Medicare for low-income beneficiaries in each region. As a result of premium and subsidy changes, the premium for any individual Part D plan can be fully covered by the subsidy in one year and not the following year. During the annual election period each fall, CMS randomly reassigns certain LIS-eligible beneficiaries to another Part D plan if they would otherwise have to begin paying a premium because their plan’s premium will be higher than the amount subsidized by the Federal government.

“Through this proposed rule, we are seeking comment on a means of reducing the number of beneficiaries subject to random reassignment while maintaining the integrity of the annual bid process,” said CMS acting Administrator Kerry Weems. “We expect changes adopted in the final rule to be effective in the 2009 benefit year.”

Specifically, CMS is proposing, under certain conditions, to allow prescription drug plan sponsors to offer a reduced premium amount for certain individuals eligible for the low-income subsidy. The proposal, which would apply in regions where there otherwise would be fewer than five prescription drug plan sponsors with a “zero-premium” plan option for limited income beneficiaries, would help to ensure there are a sufficient number of organizations offering such plans and increase the number of LIS-eligible enrollees in those regions who could remain with their current plan without having to pay a premium.

The proposed rule will be published in the Federal Register on January 8, 2008 and the final rule is expected to be issued on March 28, 2008 to ensure that the final policy is included in the Part D Rate Announcement on April 7, 2008. This will provide Part D sponsors with time to account for this policy as they calculate their Part D bids, which are due on June 2, 2008.

The proposed rule can be found here.

Centers for Medicare & Medicaid Services

Gov. Jon Corzine (D) last summer set aside $10 million in state funds to pay for the increases, and the state will receive an additional $10 million in matching federal funds. State Human Services Commissioner Jennifer Velez in a statement said that the rate increases are a “big step toward providing more access for our clients,” adding, “These new rates will benefit existing Medicaid providers” and attract new providers.

An April 2007 study by Public Citizen’s Health Research Group found that New Jersey provided the lowest Medicaid reimbursements of all the states, although the analysis included adult and child services. State Department of Human Service spokesperson Suzanne Esterman said, “Hopefully, this will place New Jersey in a much higher standing than we have been” (Johnson, AP/Long Island Newsday, 1/2).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Democrats, who were unable to reach a compromise with Republicans on a long-term reauthorization of the program, have said that they will continue to negotiate with GOP leaders. House Speaker Nancy Pelosi (D-Calif.) said that Democrats will not stop “until 10 million children receive the health care coverage they deserve” (Feller, AP/Houston Chronicle, 12/29/07).

States Unlikely To Expand SCHIP Programs Under Stopgap Funding Measure
Republican and Democratic lawmakers say that when they return to Congress in January 2008, they will try to reach a compromise on a long-term reauthorization of SCHIP, the AP/Lexington Herald-Leader reports. However, while “[d]ifferences over who should get coverage have clearly narrowed over the past months, … differences over how to pay for expansion remain considerable,” according to the AP/Herald-Leader.

Congress last month approved a continuing resolution that will maintain coverage for current beneficiaries, after Bush twice vetoed large spending increases proposed by Democrats. The “modest spending increase” has “scuttled” plans by several states that had planned to expand health coverage, the AP/Herald-Leader reports. “Few expected such a result when 2007 began,” according to the AP/Herald-Leader.

Democrats also were unable to rescind guidelines issued by the Bush administration in August 2007 that require states to enroll at least 95% of eligible low-income children before expanding eligibility to children in families with higher incomes. The policy directive will impact about half the states. Cindy Mann, executive director of the Center for Children and Families at Georgetown University, said that the rule is “definitely a step backward from where we started in 2007,” adding, “We would have seen growth in the program. We’re not going to see that growth, and by August, we’ll start to see a ratcheting down” (Freking, AP/Lexington Herald-Leader, 12/26/07).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

“A top priority throughout the fall open enrollment season has been to help beneficiaries prepare and compare their plan choices so that they could make informed decisions about switching plans. In addition, we’ve been working hard to ensure a smooth enrollment process,” said CMS Acting Administrator Kerry Weems.

The CMS has taken multiple steps to ensure that pharmacies can obtain accurate enrollment information in 2008, particularly for low-income beneficiaries. CMS has improved procedures for getting accurate plan information into the E1 eligibility system, which is the computer system that pharmacists use to identify current plan enrollment, often for beneficiaries who were reassigned to new plans, or who may not have received their new drug card. The CMS has also implemented better processing requirements for all enrollees, and CMS continues support a point-of-sale facilitated enrollment process that provides immediate coverage for people with Medicare who have Medicaid or have qualified for extra help, but aren’t enrolled in a Medicare drug plan.

The CMS also has worked aggressively to ensure a smooth transition for low-income subsidy (LIS) eligible beneficiaries who would be responsible for paying a portion of their plan premium in 2008. Earlier this fall, these beneficiaries received letters explaining steps they could take to remain in their plan by paying a small premium and a list of all the zero premium plans available in their community. Blue reassignment letters were mailed to people who qualify for the full extra help and who will be reassigned to a new plan in 2008. Tan letters were sent to beneficiaries receiving the LIS who selected a plan, but who will be responsible for paying a portion of their plan premium beginning in January 2008 unless they join a new plan. Beneficiaries who received one of these letters can receive personalized assistance at their local State Health Insurance Assistance Program (SHIP) office or their local Social Security office.

While CMS does not expect beneficiaries to encounter difficulties at the pharmacy counter due to the collaborative work among beneficiaries, partners and advocates, pharmacies, and plans, nevertheless, those beneficiaries who have newly enrolled or changed plans should keep these four tips in mind when visiting the pharmacy:

– Bring your red, white, and blue Medicare card, a photo ID, and your new drug plan membership card – these items will help the pharmacist in verifying your coverage;

– Bring an enrollment acknowledgement, confirmation letter, or the name of your new drug plan if you have not received a plan membership card – your enrollment search might take longer, but these items will assist the pharmacist in verifying your coverage;

– Keep copies of your receipts – in the rare instance where the pharmacist cannot confirm enrollment, you can work with your new plan prospectively to obtain reimbursement; and

– Don’t leave the pharmacy counter without your medicine – if you cannot pay out of pocket, call 1-800 MEDICARE for assistance or ask the pharmacist to dial the special hotline for these cases.

In addition, CMS and others have taken the following measures to smooth beneficiaries’ transition into 2008:

Online Enrollment and Toll-Free Assistance: Since November 15, 2007, Medicare’s online enrollment center has processed more than 347,000 enrollments. In the same period, its Web site has recorded over 36 million page views on http://www.medicare.gov and over 19 million page views of the Medicare Prescription Drug Plan Finder.

Since November 15, 2007, 1-800-MEDICARE has received more than three million calls and more than 3,000 customer service representatives are ready to answer questions about enrollment status. The Medicare ombudsman’s office has senior casework analysts available to resolve problems for beneficiaries who need individualized assistance because of a critical health need or financial circumstance.

At the Pharmacy: National and local chains and independent pharmacies have worked closely with beneficiaries to provide information and assistance during the open enrollment period. Thousands of pharmacies have helped beneficiaries through in-store informational days, medication reviews, and community presentations. For example, Rotz Pharmacy, an independent pharmacy in Winchester , Va. , provides a navigation guide to the http://www.medicare.gov Medicare Drug Plan Finder, other comparison tools as well as personalized consultation to beneficiaries who need help in finding a plan that best suits their needs. In-person counseling and other enrollment assistance has been provided nationwide and regionally by many chains, including: CVS; Kroger; Longs Pharmacy; Medicine Shoppe International; Rite-Aid; Target; Stop & Shop, Giant Foods and Giant Food Stores; Walgreens; and Wal-Mart.

In-person: At more than 10,000 events held nationwide, Medicare has worked closely with its partner organizations, including the National Aging Services network of state, local and community service providers, to provide enrollment counseling and sign-up opportunities where people with Medicare live, work, play and pray.

The 2007 CMS Mobile Office Tour visited 128 communities across the nation sharing information about Part D with beneficiaries. That tour highlights the personalized assistance provided by the many thousands of partners across the country who are helping beneficiaries compare their drug plan options and change enrollment if necessary.

Through the Secret Shopper initiative, CMS officials have attended over 220 events to ensure that health plans are adhering to marketing and enrollment guidelines.

Recent surveys show that a large majority of seniors enrolled in the Medicare drug benefit are satisfied with their plan and few intend to change their plan in 2008. A Wall St. Journal /Harris Interactive survey of U.S. adults age 65 or older shows that 87 percent of Medicare drug benefit enrollees are satisfied with their plan. “Our educational efforts are paying off and we will continue to provide information and assistance throughout 2008,” said Weems.

The annual open enrollment period for prescription drug coverage began on November 15 and runs through December 31, 2007. For Medicare Advantage plans only, beneficiaries can make one change in enrollment — enrolling in a new plan, changing plans or canceling a plan — between January 1 and March 31, 2008. However, beneficiaries cannot join or drop Medicare drug coverage during this time.

Beneficiaries eligible for the LIS have the ability to change plans at any time. They can continue to visit http://www.medicare.gov and view all the health and prescription plans available in their area. Users can compare plans based on costs, coverage, customer service and quality of each plan. They can also receive the same online information by calling 1-800-MEDICARE.

For more information on where to find a SHIP counselor available to provide free one-on-one help with your Medicare questions or problems, visit http://www.medicare.gov/contacts/static/allStateContacts.asp

“Given the inability to find consensus on a broader Medicare improvement package, the short term package coming before the Senate this week is the path of least resistance and is woefully inadequate. Enactment of this legislation does little to protect millions of Medicare beneficiaries from higher monthly premiums and only temporarily averts the problems beneficiaries would face finding a physician if payment cuts take place.

“The American people deserve better. It is a shame that our elected officials will go home for the holidays without helping low-income beneficiaries get the care they need by strengthening programs directly targeted at the most vulnerable older Americans.

“It also is discouraging to millions of older Americans that the administration was unwilling to consider any reductions in the billions of dollars in excess payments to Medicare Advantage plans-particularly to private fee-for-service plans, which do not have to coordinate care and have been the subject of widespread marketing abuses-in order to help improve Medicare.

“As the 2008 debate returns to Medicare, AARP will again be pursuing policies that protect beneficiaries from excessive premiums and strengthen assistance for low-income individuals.”

American Association of Retired Persons