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Groups call on Medicare to ease drug transition

Thousands of poor elderly and disabled Americans have been unable to obtain their medications under Medicare’s new prescription drug benefit, 45 consumer groups charged in a letter released Wednesday calling for government action.
/ Source: Reuters

Thousands of poor elderly and disabled Americans have been unable to obtain their medications under Medicare’s new prescription drug benefit, 45 consumer groups charged in a letter released Wednesday calling for government action.

The groups cited a list of problems low-income beneficiaries have faced when trying to use the coverage since the benefit took effect Jan. 1.

“The result is that thousands of America’s most needy are going without needed medications,” they wrote.

Low-income beneficiaries previously received their medicines through Medicaid, the nation’s insurance program for the poor, but were supposed to be automatically enrolled into the new benefit under Medicare, which covers older or disabled people.

Some were not enrolled at all, while others were charged unnecessary fees, the groups said. Some patients also were asked to pay up front or were not found in the computer system, they added.

In some cases, patients were left without drugs to treat serious and chronic conditions, the groups said.

“This is quickly growing into a widespread, national public health crisis,” Jeanne Finberg, an attorney for the National Senior Citizens Law Center, said in a statement.

Representatives for Centers for Medicare and Medicaid Services, or CMS, could not be immediately reached for comment on the letter.

Last month, agency officials said the program was off to a strong start, with about 6.2 million so-called dual eligibles enrolled.

The letter comes after several U.S. states have said they would step in to cover drugs for poorer beneficiaries. Connecticut, Maine, Massachusetts, New Hampshire, North Dakota and Vermont have passed such laws, according to the advocacy group Medicare Rights Center.

On Wednesday, the groups called on Medicare to “ensure that states are given a clear message that any stop-gap Medicaid coverage for dual eligibles will be paid by CMS.”

They also asked the agency to “ensure that all dual eligibles be able to leave a pharmacy with medically necessary prescriptions.”

While Medicare officials have taken some steps to make sure drug coverage for poorer beneficiaries is not disrupted, the groups said those efforts are not being implemented.

“The necessary information is not filtering down to the operational level at either plans or pharmacies,” they said.

Patients and pharmacists trying to access Medicare’s hotline could not get through or could not get answers to their questions, the groups also said.