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US drug plan frustrates patients, pharmacists

Posted on: Friday, 20 January 2006, 18:23 CST

By David Lawder

WASHINGTON (Reuters) - Patients, pharmacists, physicians and state officials expressed extreme frustration over foul-ups with the new Medicare drug benefit on Friday, urging lawmakers to simplify a plan they called confusing and fraught with potentially life-threatening problems.

Hundreds of thousands of elderly and disabled Americans have encountered difficulties obtaining prescription drugs since the new Medicare Part D program went into effect January 1, and many were being turned away empty-handed.

The program, estimated to cost $724 billion over the next 10 years, relies on private insurers, pharmacies and other health care companies to provide drugs coverage for Medicare's 42 million beneficiaries.

"I took my insurance card to the pharmacy on January 1, along with my prescriptions. The computer rejected my card as if I did not exist," Ruth Grunberg of Cortland, New York, told a gathering of Democrats in the U.S. House of Representatives on Friday.

Grunberg, who enrolled in a Part D drug plan run by United Healthcare, embarked on a nine-day odyssey of phone calls to her insurer, pharmacies, lawmakers and even the local newspaper to try to straighten things out.

So far, at least 26 states and the District of Columbia have stepped in to pay for drugs for patients also enrolled in Medicaid, the federal-state program that covers the poor. Those beneficiaries were supposed to be automatically switched over to the new benefit but some did not show up on Medicare rolls in computer systems, leaving many without drugs.

Arnaudville, Louisiana pharmacist Marlene Brantley said she has dispensed thousands of dollars worth of drugs to needy patients, but has no idea whether her store will be reimbursed.

Several witnesses told Democrats in the hearing-like meeting, led by California Rep. Henry Waxman, that they expect drug costs for Medicaid recipients to rise, because states can no longer benefit from pharmaceutical company rebates.

"We expect to pay an additional $12 million for a less comprehensive benefit," said Jude Walsh, special assistant to Maine's Office of Health Policy and Finance.

Waxman, who opposed the 2003 legislation that created the drug benefit, which aimed to broaden coverage and hold down drug prices through market competition, said the Part D problems illustrate the need for reform legislation.

But Health and Human Services Secretary Mike Leavitt said Medicare officials were working to fix the glitches in various states and that the situation was improving. "In large measure it's getting better every day," Leavitt told reporters during a conference call,

(Additional reporting by Lisa Richwine)

Source: REUTERS

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