zimv20
Jan 16, 2006, 06:43 PM
link (http://nytimes.com/2006/01/16/politics/16drug.html?hp&ex=1137474000&en=f9353ff31dd315be&ei=5094&partner=homepage)
With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug.
The actions came after several states declared public health emergencies, and many states announced that they would step in to pay for prescriptions that should have been covered by the federal Medicare program.
Republicans have joined Democrats in asserting that the federal government botched the beginning of the prescription drug program, which started on Jan. 1. People who had signed up for coverage found that they were not on the government's list of subscribers. Insurers said they had no way to identify poor people entitled to extra help with their drug costs. Pharmacists spent hours on the telephone trying to reach insurance companies that administer the drug benefit under contract to Medicare.
Many of the problems involve low-income people entitled to both Medicare and Medicaid.
In a directive sent to all Medicare drug plans over the weekend, the Bush administration said they "must take immediate steps" to ensure that low-income beneficiaries were not charged more than $2 for a generic drug and $5 for a brand-name drug.
In addition, it said insurers must cover a 30-day emergency supply of drugs that beneficiaries were taking prior to the start of the new program.
In an interview yesterday, Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said that "several hundred thousand beneficiaries who switched plans" in December may have had difficulty filling prescriptions in the last two weeks.
In California, officials estimate that 200,000 of the state's 1.1 million low-income Medicare beneficiaries had trouble getting their medications.
Despite these problems, Dr. McClellan said, Medicare is now covering one million prescriptions a day. With the latest corrective actions, he said, "all beneficiaries should be able to get their prescriptions filled."
In the past, such predictions proved to be premature. New problems appeared as old ones were solved, and some insurers were slow to carry out federal instructions.
Since the program began on Jan. 1, many low-income people have left pharmacies empty-handed after being told they would have to pay co-payments of $100, $250 or more.
About 20 states, including California, Illinois, Ohio, Pennsylvania and all of New England, have announced that they will help low-income people by paying drug claims that should have been paid by the federal Medicare program.
"The new federal program is too complicated for many people to understand, and the implementation of the new program by the federal government has been awful," said Gov. Tim Pawlenty of Minnesota, a Republican. On Saturday, he signed an emergency executive order making the state a "payer of last resort" for the out-of-pocket drug costs.
The Bush administration said it was rushing to provide insurers with correct information about the extra subsidies available to low-income people enrolled in their plans.
(more)
hm, another boondoggle. and it's a plan that's been trumpeted by the WH ever since its passage. it'll be interesting to see if it has any effect on bush's poll numbers.
With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug.
The actions came after several states declared public health emergencies, and many states announced that they would step in to pay for prescriptions that should have been covered by the federal Medicare program.
Republicans have joined Democrats in asserting that the federal government botched the beginning of the prescription drug program, which started on Jan. 1. People who had signed up for coverage found that they were not on the government's list of subscribers. Insurers said they had no way to identify poor people entitled to extra help with their drug costs. Pharmacists spent hours on the telephone trying to reach insurance companies that administer the drug benefit under contract to Medicare.
Many of the problems involve low-income people entitled to both Medicare and Medicaid.
In a directive sent to all Medicare drug plans over the weekend, the Bush administration said they "must take immediate steps" to ensure that low-income beneficiaries were not charged more than $2 for a generic drug and $5 for a brand-name drug.
In addition, it said insurers must cover a 30-day emergency supply of drugs that beneficiaries were taking prior to the start of the new program.
In an interview yesterday, Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said that "several hundred thousand beneficiaries who switched plans" in December may have had difficulty filling prescriptions in the last two weeks.
In California, officials estimate that 200,000 of the state's 1.1 million low-income Medicare beneficiaries had trouble getting their medications.
Despite these problems, Dr. McClellan said, Medicare is now covering one million prescriptions a day. With the latest corrective actions, he said, "all beneficiaries should be able to get their prescriptions filled."
In the past, such predictions proved to be premature. New problems appeared as old ones were solved, and some insurers were slow to carry out federal instructions.
Since the program began on Jan. 1, many low-income people have left pharmacies empty-handed after being told they would have to pay co-payments of $100, $250 or more.
About 20 states, including California, Illinois, Ohio, Pennsylvania and all of New England, have announced that they will help low-income people by paying drug claims that should have been paid by the federal Medicare program.
"The new federal program is too complicated for many people to understand, and the implementation of the new program by the federal government has been awful," said Gov. Tim Pawlenty of Minnesota, a Republican. On Saturday, he signed an emergency executive order making the state a "payer of last resort" for the out-of-pocket drug costs.
The Bush administration said it was rushing to provide insurers with correct information about the extra subsidies available to low-income people enrolled in their plans.
(more)
hm, another boondoggle. and it's a plan that's been trumpeted by the WH ever since its passage. it'll be interesting to see if it has any effect on bush's poll numbers.
