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It's D-Day for Medicaid Clients as Drug Coverage
Switches to Medicare
Jan. 1, 2006 - A federal district judge ruled last
week that federal courts lack the power to order continuation of
existing drug benefits for people with Medicare and Medicaid, as drug
coverage shifts today from Medicaid to Medicare Part D. Denial of drug
coverage is just one of the confusing circumstances that may face the
more than six million "dual eligibles" in this new year.
The court decision says that people denied medicine
must contest that denial, individual by individual, before the Centers
for Medicare and Medicaid Services prior to seeking court protection.
The plaintiffs, led by the Medicare Rights Center
of New York, were eight consumer organizations who say they will bring
an immediate appeal of the ruling.
Robert M. Hayes, the president of the
Medicare Rights Center, made
the following statement:
Nothing in this ruling suggests that the oldest,
poorest and frailest Americans are safe. On January 1st the neediest
Americans face potentially catastrophic disruptions in their access to
needed medicine. In the real world, people cut off from life-sustaining
medicine cannot survive the delay of an agency appeal. The
responsibility for the health and safety of these frail Americans rests
squarely with the Bush Administration.
The text of the courts decision can be found at:
http://www.nysd.uscourts.gov/rulings/05CV09549_opinion_122905.pdf
Although the Centers for Medicare & Medicaid
Services (CMS) announced contingency plans for those who fall through
the cracks and gave assurances that the transition will go smoothly,
dually eligible beneficiaries, their caretakers, and advocates are
concerned that many will not be able to get the drugs they need this
January.
The Center for Medicare Advocacy suggests several
questions dual eligibles should ask, and several steps they can take, in
order to ensure the smoothest transition possible. For the Center's
advice, read below or click to:
http://www.medicareadvocacy.org/PartD_DualEligiblesAfter010106.htm
Note:
ElderLawAnswers.com contributed to this report.
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