Governor’s Budget Eliminates EPIC and Medicaid Wrap Coverage for Prescription Drugs
ALBANY, N.Y., Jan. 28 /PRNewswire-USNewswire/ – Members of the New York State Medicare Part D Coalition, including AARP, the Empire Justice Center, Medicare Rights Center, The Legal Aid Society, Selfhelp Community Services and Statewide Senior Action, called on the New York Legislature today to reject the Governor’s proposed budget cuts to programs that help the elderly and poor pay for the prescription drugs they need.
The Governor’s Budget proposal would eliminate more than $50 million in “wrap around” coverage provided through the Elderly Pharmaceutical Insurance Coverage (EPIC) Program and Medicaid programs for drugs not covered by the federal Medicare program. This proposal could negatively impact hundreds of thousands of low-income and elderly New Yorkers who rely on these programs to help pay for the medication they need.
The current Medicaid wrap pays for four specific categories of drugs — atypical antipsychotics, anti-depressants, anti-retrovirals used to treat HIV/AIDS, and anti-rejection drugs used by organ and tissue transplant recipients — when a Medicare prescription drug plan refuses to cover them.
These budget changes contradict the state’s assurance last year that the elderly and poor would not go without the medication they need.
“AARP strongly believes that no one should walk away from the pharmacy counter without the prescription drugs they need,” stated
Lois Aronstein, AARP New York State Director. “With these changes, the state is shifting the cost and burden onto its most vulnerable populations.”
“New York’s Medicaid wrap provides a critical safety net to New York’s poorest and most vulnerable Medicare beneficiaries — organ transplant recipients and people living with mental illness or HIV infection,” says
Cathy Roberts, a senior paralegal with the Empire Justice Center.
“Right now CMS’ hotline is overwhelmed with Part D complaints, even when EPIC continues to provide a safety net for New York’s seniors. We shudder to think of what will happen if EPIC slams its doors shut,” said
David Silva, Assistant Director of the Evelyn Frank Legal Resources Program at Selfhelp Community Services.
“Every year, the Medicare Rights Center receives calls from thousands of people with Medicare who have tried to appeal for Medicare Part D coverage on their own, but find that the process can be challenging, even impossible, to navigate. New York should protect EPIC enrollees by ensuring access to medically necessary prescriptions when they are not available under Part D and by helping enrollees through the Medicare appeals process,” stated
Dina Wizmur, Deputy General Counsel for the Medicare Rights Center.
“In less than three months, New York already saved $500,000 to the EPIC program by winning appeals against Part D plans and forcing the plans to pay for drugs. This system, negotiated in last year’s budget, should be given a chance to work for the State and vulnerable seniors,” said
Lisa Sbrana, Supervising Attorney of The Legal Aid Society’s Health Law Unit.
“Many of New York’s most vulnerable seniors will be very surprised and angry to find out that their drugs are no longer covered by EPIC. Rather than seeking alternatives, many will try to pay out of pocket; others will stop taking their scripts. Neither of these options is acceptable,” stated
Justin Cunningham, Executive Director of Statewide Senior Action.
According to the Center for Studying Health System Change in Washington, D.C, one in seven Americans under age 65 went without prescribed medicines in 2007. In addition, three in 10 low-income Americans said they had been unable to fill a prescription because of cost, and nearly one in four adults on Medicaid or in a state insurance program said they were having difficulty affording their medication.
AARP’s Public Policy Institute Watchdog Report has documented that drug companies have substantially raised prices on 220 brand name prescription drugs over the past few years. The Rx Watchdog report found that prices of brand name drugs raised an average of 7.4 percent in 2007 — nearly two and a half times the rate of general inflation.
AARP New York has over 2.6 million members. AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, published bimonthly; AARP Bulletin, our monthly newspaper; AARP Segunda Juventud, our bimonthly magazine in Spanish and English; NRTA Live & Learn, our quarterly newsletter for 50 + educators; and our website, www.aarp.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
SOURCE AARP New York
