Medicare Drug Program Leads to Public Health Emergencies

Arkansas Gov. Mike Huckabee (R) has declared a public health emergency in the wake of the 1 January implementation of the Bush Administration Medicare prescription drug plan. Louisiana is broke and uncertain of how it can help its elderly and poor. "Bugs in the new Medicare Part D program, which went into effect Jan. 1, include computers telling pharmacists some patients, many of whom have had prescriptions filled at the same pharmacies for years, are not eligible to receive drugs and that some never enrolled, even though they have cards."

Emergency action has also been taken in Alabama, California, Connecticut, Illinois, Kansas, Massachusetts, Minnesota, New Hampshire, North Dakota, Oregon, Pennsylvania and Vermont, as well as an unknown number of other states: AP says "about 20" in total.

Emergency legislation is pending in New York. States plan to ask the federal government for reimbursement, but there is no "mechanism in place to reimburse states," according to the Shreveport Times.

The Miami Herald reports that seniors are victims of Medicare computers -- with out-of-date databases. Customers show up with their ID cards, but the pharmacy computer says they aren't covered.

Baeteena Black, executive director of the Tennessee Pharmacists Association said, "I've talked to pharmacists who have been in practice for 25 years who say this is the most difficult time they've ever had. They're saying we have it rough right now, but the patients have it even worse."

A pharmacist near Pittsburg details the hassle: "One of our pharmacists was on hold 80 minutes and never got to talk to anybody. We've been put on hold, disconnected and got busy signals calling individual insurance plans, calling case workers, family members and insurance companies."

Then there's the cost. Medicare and Medicaid coverage was merged in this new system, and many Medicaid customers are being presented with enormous bills. On Friday, the Centers for Medicare and Medicaid Services reminded insurers that low-income beneficiaries should not be charged more than $5 for brand-name or more than $2 for generic drugs.

About 42 million disabled and older people must chose between competing private drug plans designed to subsidize the cost of their prescriptions; the penalty-free sign-up period ends 15 May. Medicare is subsidizing almost 3,000 plans in 34 regions, according to Bloomberg. And about 6 million elderly, low-income and disabled people were automatically switched from Medicaid to the Medicare plan on 1 January; much of the current disarray surrounds these beneficiaries.

In 2003, Congress created the Medicare drug program, known as Part D. The standard Part D plan includes a $250 deductible plus premiums ranging from $20 - 37 a month. Beneficiaries are responsible for 100% of the first $250; 25% of the cost from $251 - 2,250; 100% of the cost from $2,251 - 5,100; and only 5% of cost greater than $5,100.

This is the largest expansion of Medicare since its creation in 1965.

Sen. Norm Coleman (R-MN) says the Senate will hold hearings on the implementation next month. "People should not be in a position where they're not able to get their medicine. That's totally contrary to the whole concept here. I was very angry about the way it was implemented, this piece of it. But I'm very hopeful that because voices have been raised and the pressure has been put on, that they'll take care of it very quickly."

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