January 12, 2006
AR Delegation Requests Federal Government To Reimburse States for Poor Implementation of Medicare Drug Benefit
WASHINGTON, D.C. - In light of significant administrative problems created by the newly implemented Medicare Part D prescription drug benefit, Senators Blanche Lincoln and Mark Pryor, along with U.S. Representatives Marion Berry (AR-01), Vic Snyder (AR-02), Mike Ross (AR-04), and John Boozman (AR-03), today sent a letter to Health and Human Services Secretary Mike Leavitt and Mark McClellan, Administrator of the Centers for Medicare and Medicaid Services (CMS), requesting that Arkansas be reimbursed for the costs it is incurring while the agency seeks to correct problems with implementation of the new Medicare drug benefit. Thousands of beneficiaries who have dual eligibility status, those eligible for both Medicaid and Medicare, have been either wrongly classified or inadvertently left out of the system, and as a result are facing substantially higher co-payments for medications.
The text of the letter is provided below.
January 12, 2006
Mark McClellan, M.D., Ph.D.
Centers for Medicaid and Medicare Services
314 G Hubert H. Humphrey Building
200 Independence Ave, SW
Washington D.C. 20201
Dear Dr. McClellan:
As you are aware, the recently implemented Medicare Part D system has posed a series of problems for both beneficiaries and pharmacists. Since the start of the program twelve days ago, thousands of dual eligibles have been faced with obstacles in obtaining needed medications. These beneficiaries either have not been entered into the system or have been wrongfully classified as standard Medicare beneficiaries therefore being subject to substantially higher co-payments.
Local pharmacists have been working endlessly to assist these beneficiaries in obtaining needed medications. Some of the pharmacists in our state have gone as far as absorbing the cost of these beneficiaries' medications in the hopes of being reimbursed once the problems with the system are resolved. Others simply cannot afford to bear this financial burden and continue to keep their doors open. As a result, they have had to deny beneficiaries their prescriptions. Consequently, beneficiaries are losing access to needed life-saving medications. Lack of medicine or disruption in medication routine will ultimately lead to increased doctor and hospital visits, therefore creating unnecessary increased costs to our health care system.
In light of this situation, Governor Huckabee has issued an executive order to use operating funds from the Arkansas Health and Human Services Department to reimburse pharmacists who are unable to properly bill the Medicare Part D health plans. We are pleased with the Governor's action, as it will ensure that beneficiaries' prescriptions will be filled and pharmacists will be reimbursed. Under the executive order, the state will provide this funding from January 1st through January 15th. We ask that you ensure that Arkansas is reimbursed for the costs the state is incurring during this time.
We appreciate your attention to this matter and look forward to your response on how the Centers for Medicaid and Medicare Services is resolving this serious problem facing beneficiaries and pharmacies across our nation.