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RespiteMatch.com Health Blog

News, Opinions and Advice regarding the U.S. Home Health Care Industry

Insurers told to provide Medicare drugs-NY Times

January 16th, 2006 by RespiteMatch.com

Mon Jan 16, 2006 12:08 AM ET

WASHINGTON, Jan 16 (Reuters) - The Bush administration has told health insurers under contract to the new Medicare drug plan that they must provide a 30-day supply of any drug a beneficiary was previously taking after tens of thousands of people were unable to get medicines promised by Medicare, the New York Times reported on Monday.

In a directive sent to all Medicare drug plans over the weekend, the Bush administration also said insurers “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, according to the Times.

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 Medicare’s new prescription drug program, which started on Jan. 1, the Times said.

People who had signed up for coverage found that they were not on the government’s list of subscribers and insurers said they had no way to identify poor people entitled to extra help with their drug costs, the paper reported.

Dr. Mark McClellan, administrator of the federal Centers for Medicare and Medicaid Services, told the Times that “several hundred thousand beneficiaries who switched plans” in December may have had difficulty filling prescriptions in the last two weeks.

Despite these problems, Medicare is now covering one million prescriptions a day, McClellan said. With the latest corrective actions, “all beneficiaries should be able to get their prescriptions filled,” McClellan told the paper.

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 Times said.

“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 Minnesota Gov. Tim Pawlenty, 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 Times reported.

Any of the 42 million Medicare beneficiaries can sign up for the new drug coverage. Federal officials say that a surge in enrollments occurred in late December. About 6.2 million low-income people who had drug coverage under Medicaid were automatically enrolled in Medicare drug plans, and some of them have switched to other Medicare plans, the Times said.

Filed under: Policy & Politics |

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