glitches in medicare part D

[David Farber <dave () farber net>]

Begin forwarded message:

From: Suzanne Johnson <sjohnson () pobox com>
Date: January 9, 2006 11:40:19 AM EST
To: dave () farber net
Subject: glitches in medicare part D





it is really bad in NV also.  I know of a woman diagnosed with  
pneumonia at the end of Dec who has not been able to get the  
antibiotics her MD prescribed.  She has spent hours on the phone with  
Medicare, healthplan and other folks..still no antibiotics.   
Apparently computers and/or databases that need to talk to each other  
are not doing so...and it appears that data that was to have been  
made available by Medicare either was not available or not accessible.

suzanne johnson    pob 788        genoa, NV  89411




> http://www.nytimes.com/2006/01/08/national/08medicare.html? 
> pagewanted=print
>
> ----------------------------------------------
>
> January 8, 2006
>
> States Intervene After Drug Plan Hits Snags
>
> By ROBERT PEAR
>
> WASHINGTON, Jan. 7 - Low-income Medicare beneficiaries around the  
> country were often overcharged, and some were turned away from  
> pharmacies without getting their medications, in the first week of  
> Medicare's new drug benefit. The problems have prompted emergency  
> action by some states to protect their citizens.
>
> Although there are no hard numbers, concerns expressed by state  
> officials and complaints from pharmacists suggest a widespread  
> pattern of problems.
>
> At least four states - Maine, New Hampshire, North Dakota and  
> Vermont - acted this week to make sure poor people received the  
> drugs they were promised but could not obtain through the federal  
> Medicare program.
>
> Gov. Jim Douglas of Vermont, a Republican, said the state would pay  
> drug claims for low-income people until the federal government  
> fixed problems in the new program, known as Part D of Medicare.  
> Michael K. Smith, the state's secretary of human services, said,  
> "The federal system simply is not working."
>
> On Thursday, the Vermont Legislature passed a bill declaring,  
> "There is a public health emergency due to the federal  
> implementation of Medicare Part D, which has resulted in serious  
> operational problems, causing Vermonters to be turned away at the  
> pharmacy without the drugs they need."

---------------------clip----------------
> "Many are being charged unaffordable co-payments for prescription  
> drugs - co-pays much higher than they are supposed to be. Too many  
> of them are leaving pharmacies without their prescriptions."
>
> Thomas T. Noland Jr., a spokesman for Humana Inc., a major national  
> insurer, said that some problems were "to be expected in a new  
> program with lots of new enrollment taking effect all at once."
>
> Cynthia G. Tudor, a senior Medicare official, told insurers on  
> Wednesday that they must "immediately make improvements" to "ensure  
> that all beneficiaries get their prescriptions filled at the point  
> of sale."
>
> In a memorandum to insurers, Ms. Tudor said she had received  
> "numerous reports" that they were "inappropriately denying some  
> scripts," or claims. In many cases, she said, insurers are not  
> providing the data that pharmacies need to file claims and get paid.
>
> Dr. Mark B. McClellan, administrator of the federal Centers for  
> Medicare and Medicaid Services, said on Saturday that he was  
> working closely with states to address their concerns and to help  
> individual patients. "We are filling close to a million  
> prescriptions a day, including hundreds of thousands for low-income  
> beneficiaries," Dr. McClellan said. "Many, many people are getting  
> the prescriptions they need."
>
> But in an interview on Friday, Stan Rosenstein, the Medicaid  
> director in California, said: "We are hearing more and more  
> complaints. A significant number of people are not getting their  
> prescriptions. That has us very troubled."
> Drug benefits are delivered by private insurers under contract to  
> Medicare. The federal government is supposed to compute the subsidy  
> available to each low-income beneficiary. But Michael Polzin, a  
> spokesman for Walgreens drug stores, said that, in many cases, that  
> information had not been shared with insurers or pharmacists.
> ---------------------clip----------------------
>
> Beverly R. Churchwell, an aide to the Alabama commissioner, said:  
> "Some Medicare beneficiaries have not been able to get their  
> medications. They are being turned away at the pharmacy."
> John J. Morris, 42, of Ware, Mass., who has diabetes and multiple  
> sclerosis, signed up for a Medicare drug plan on Nov. 16. The  
> insurer told him his co-payments would not exceed $5, he said, but  
> at the pharmacy this week, he was told he had to pay $23 for each  
> of three drugs.
>
> "I could not afford it," Mr. Morris said, "so I was not able to get  
> my insulin or my M.S. drug."
>
> In Oregon, Sandy K. Hata, a field manager for the State Department  
> of Human Services, said: "We've had calls from people in tears who  
> could not get their medications. These people were being asked to  
> pay a $250 deductible and hundreds of dollars in co-payments."
>
> Jane-ellen A. Weidanz, the Medicare project manager at the Oregon  
> Department of Human Services, said, the $250 deductible "is hitting  
> people very hard," adding: "People are very angry and very upset.  
> They are yelling at us. They feel that we lied to them. They feel  
> Medicare lied to them. They feel they cannot trust anything we say  
> about this program."

------------clip----------------


-------------------------------------
You are subscribed as lists-ip () insecure org
To manage your subscription, go to
 http://v2.listbox.com/member/?listname=ip

Archives at: http://www.interesting-people.org/archives/interesting-people/