California starts emergency program to pay for seniors’ medicine
January 13th, 2006 by RespiteMatch.comFriday, January 13, 2006
(01-13) 00:03 PST SACRAMENTO, (AP) —
California will buy prescription drugs for senior citizens and the disabled who cannot get their medicine because of bureaucratic foul-ups under the new federal Medicare program, Gov. Arnold Schwarzenegger announced.
The governor on Thursday ordered state health officials to cover pharmacy costs for prescription drugs for five days and said the state Legislature planned to extend the emergency coverage for another 10 days.
Under the emergency plan, the state will temporarily supply its most vulnerable residents with “lifesaving medications they are in danger of losing because of significant problems with the new federal Medicare prescription drug program,” Schwarzenegger said in a statement.
“Starting later today, the state will be the payer of last resort,” he said.
He did not estimate the cost but it could run to millions of dollars. The governor said he would ask the federal government to reimburse the state costs.
About 1 million Californians who are eligible for both federal Medicare and state-run Medi-Cal health insurance were automatically switched from their current prescription drug coverage to Medicare coverage as of Jan. 1 under a plan touted by the Bush administration as a key reform.
California is home to about 1 in 6 of the eligible recipients nationwide.
But the Medicare program isn’t monolithic. Instead, seniors obtain coverage through one of hundreds of private drug plans that take part in and are reimbursed under the federal program.
Some of the mainly low-income recipients have reported trouble obtaining their medication from pharmacies that have been unable to confirm they are covered. In some cases, people who enrolled in plans have discovered they aren’t listed as participating when pharmacies check their computers.
Other beneficiaries found they were listed as owing a $250 deductible when they should have been paying only a few dollars per prescription.
Federal officials have estimated an error rate of about 20 percent, meaning about 200,000 Californians are at risk of being unable to get their medications, state Health and Human Services Secretary Kim Belshe said in a conference call Thursday.
The California Medical Association applauded the emergency order.
“The Gov. has saved thousands of lives today,” Dr. Jack Lewin, chief executive officer, said in a statement. “This may be the single most-important health-care action he has taken as governor for the nearly 1 million of the neediest patients in California.”
Medicare is working “very diligently” to solve the problems, said Jeff Flick, regional administrator for the federal Centers for Medicare & Medicaid Services.
“This is a program that is quite large and is working very well for most people. There are some glitches and some problems,” he said in the conference call.
Flick also said he would work with the state “to help them recover whatever funds are expected.”
New Hampshire, South Dakota, Vermont, Connecticut, Massachusetts and North Dakota all previously announced plans that would enable low-income people to get their medicine if pharmacists were having trouble confirming coverage through the new Medicare benefit. Arkansas and Illinois announced their own plans Wednesday.
New York officials have said the state already had in place a program that would allow its Medicaid program to cover prescription expenses for about 570,000 low-income residents if they experience problems with the new program.
___
