Administration Tells Insurers To Honor Medicare Rx Claims

BY MATT BRADY

The Bush administration is requiring insurers to provide needed drugs to Medicare beneficiaries while startup problems in the new pharmacy benefit are resolved.

The problem has already been confronted at the state level. Around 20 states have taken measures to ensure beneficiaries will be able to receive their prescription drugs. Some states declared the situation a public health emergency, and others said their state would pay for prescription drugs that should be covered by the federal program.

“We understand the federal government is working hard to correct the problems with this new prescription drug program, but the fact is that a lot of vulnerable Ohioans who expected affordable copayments for their prescriptions are not getting the benefit that they were promised,” said Ohio Governor Bob Taft. “Until the problem is fixed, we are doing what we can to help our citizens afford their medications.”

Illinois Gov. Rod Blagojevich said it was “unacceptable” that problems in the system could result in seniors being unable to fill their prescriptions. “Hopefully, the glitches with the federal program will be worked out soon, but until then, we’re going to take care of those who need their prescription drugs to remain healthy,” he said.

The federal requirement would ensure seniors have a 30-day supply of any drug they had been taking previously, and it mandates poor seniors cannot be charged more than $5 for their prescriptions.