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Governors Take Action to Help Low-Income Seniors as Medicare Drug Program Falters

Medicare Rights Center wants New York to follow states that have declared emergencies

Jan. 11, 2006 – Governors – both Democrats and Republicans – are beginning to take steps to have their state's pick up the tab on drugs for low-income senior citizens whose drug coverage has not been picked up by Medicare. These are primarily those on both Medicare and Medicaid, who have not yet been approved by Medicare after the mandated switch of their drug coverage from Medicaid. In New York, the Medicare Rights Center, says complaints continue to mount there and they have called on Gov. George Pataki (R-N.Y.) to declare a public health emergency.

The MRC says there are over a half million New Yorkers in this "dual eligible" category and the complaints that many have not able to get the drug prescriptions filled, since the new law took effect on January 1, are coming from consumers, caregivers, health professionals and pharmacists.

“Very sick, very poor, older and disabled New Yorkers are calling our hotline desperate for help because they are leaving drugstores empty handed,” said Robert M. Hayes, president of the Medicare Rights Center, a consumer service group which provides a Medicare counseling hotline for New Yorkers.

Gov. John Lynch (D-N.H.) is one of those who has already take action for New Hampshire seniors. Yesterday he signed emergency legislation to fund the state's efforts to make sure citizens can still get their prescription drugs, despite the problems with the implementation of the new federal prescription drug program.

Gov. Lynch had already issued an Executive Order on Friday directing the Department of Health and Human Services to pay claims for prescription drugs just as it would have under the Medicaid system in place until Dec. 31, in cases where the federal government's Medicare Part D system is not working. His office says the state will then seek reimbursement from the Medicare Part Drug Plans or the federal government, where appropriate.

North Dakota's Republican Governor, John Hoeven, has also acted. He authorized the state Department of Human Services Medicaid program to provide an emergency 30-day supply for individuals unable to fill prescriptions through Medicare Part D until January 23, "while the federal government and the prescription drug plans resolve their implementation issues."

A news release from his office said assistance will continue to be provided on a case-by-case basis through February 15.

“Medicare Part D is a federal benefit, but they are clearly having difficulty implementing this new program in a timely fashion,” Hoeven said. “Going without prescriptions is not an option for our seniors and disabled, so the state of North Dakota will step up to ensure that they continue to get their medications until the federal government resolves their difficulties.”

The North Dakota governor's office said that pharmacies and long-term care facilities have reported problems that range from incomplete enrollment information, prescription drug plans not providing first fills as required by Medicare, and errors related to charging low-income people inappropriately for co-pays and deductibles. In addition, the state Department of Human Services is receiving about 100 calls and between 50 and 70 e-mails a day.

New Hampshire's Gov. Lynch said yesterday, "The fact that the federal government did not anticipate and prevent these problems is inexcusable. The federal government created a situation where some of our most vulnerable people were not getting the prescription drugs they need to live. They put a lot of bureaucratic steps into their plans, but they left out the most important one - guaranteeing that people left the pharmacy with their prescription drugs,"

Gov. Lynch and several legislative leaders met with pharmacies Monday afternoon. "The pharmacists told us that the new system is working as the fail-safe that we intended," he said. From Friday evening through Monday, pharmacists used the state's emergency system to fill 228 prescriptions.

"Those are 228 prescription medications that our citizens would have been forced to go without - putting their lives and health at risk - if we hadn't acted," Gov. Lynch said.

The MRC says Connecticut, Maine, Massachusetts and Vermont, have joined New Hampshire and North Dakota in taking emergency actions to provide prescription drugs for these low-income senior citizens.

This problem was anticipated by the MRC, who led seven other plaintiffs in filing a lawsuit on behalf of those with both Medicaid and Medicare, who were to lose their Medicaid drug coverage.

The group filed an appeal that is pending in Second Circuit Court of Appeals in Manhattan.

A copy of the letter to Gov. Pataki and examples of the problems that New Yorkers are having accessing their prescriptions is available on the Medicare Rights Center’s website at http://www.medicarerights.org/pataki_letter_re_duals.html . 

The Medicare Rights Center (MRC) claims to be the largest independent source of Medicare information and assistance in the United States.  Founded in 1989, MRC says it helps older adults and people with disabilities get high-quality, affordable health care.

Located at 1460 Broadway, New York, NY  10036 (Telephone 212-869-3850) their Web site is http://www.medicarerights.org

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