State Senator Leticia Van De Putte, District 26

For Immediate Release
January 24, 2006

OP-ED

Medicare glitches put Texans at risk

As both a State Legislator and Pharmacist, I want to inform you of problems Texans are experiencing with the new federal prescription program, Medicare Part D, and share what we in the state legislature are attempting to do to help our senior citizens and disabled. Though I hope the end result of this federal program will ultimately be positive, the troubles we are experiencing now are affecting our most vulnerable population, individuals who require life sustaining medicines.

For more than 26 years I have counseled a diverse group of patients on a number of pharmaceutical benefit programs. Unfortunately, Medicare Part D has been among the most difficult programs for patients to utilize and understand. Most of the problems have been experienced by "full dual eligibles" - the approximately 313,000 Texans including 23,000 people in Bexar County who are enrollees of both Medicare and Medicaid and whose medicines were formerly covered under the Texas Medicaid program. For this population the new Medicare Part D prescription program began January 1, 2006.

The problems stem from a faulty computer system created by the Centers for Medicare and Medicaid Services (CMS), the agency of the federal government charged with implementing the prescription program. The inability of the computer system to work properly caused long waiting periods at pharmacies, who tried desperately to aid their patients. As I worked in the pharmacy the first few weeks of January, I saw the frustration and fears of our pharmacy staff and most importantly the desperate situation of our patients. The computer glitches include wrong cost-sharing information for low-income beneficiaries, thus enrollees are being asked to pay a $250.00 co-pay when it should be less than $5.00. Understandably, this causes alarm and stress to both pharmacists and beneficiaries. Pharmacy associations have concluded that only about one out of every three "full dual eligibles" is receiving his or her medicines without some type of difficulty. This is unacceptable.

Aside from the complications and inconveniences there is a more fundamental dilemma: the health of our friends and neighbors. The very program intended to help keep people healthy is putting them at risk through its implementation. For some, prescription medicines are vital to sustaining life and improving quality of life. That is why we must correct these problems now before a tragedy occurs.

Since the program started on January 1, about 21 states have taken immediate action including reactivating their state Medicaid program to cover prescriptions.

Currently, the Governor is weighing what options are available in Texas. Although this is a federal program, it is the moral responsibility of state officials to act to provide a safety net for low-income beneficiaries. My staff and I have been in constant communication with the Health and Human Service Commission to help resolve immediate problems in getting prescriptions filled by Texans caught in the cross-fire of these implementation problems. I have also strongly urged the Governor to take temporary emergency action to alleviate the suffering I have seen firsthand.

I hope that Texans will be well-served by this program once we get past these serious implementation problems. However, we must ease the implementation process, so there are no patients left without the prescriptions they so desperately need. The effective administration of Medicare Part D is an important health issue and should be of great concern to us all. And although it is a federal program, state officials must step in and ease the transition burden for Texans. Failure to do so could mean the difference between life and death.

(*) Governor Rick Perry took emergency action on this issue as of January 25, 2006. Effective immediately, the Texas Health and Human Services Commission (HHSC) will provide Medicaid prescription drug coverage for low-income Texans who are inappropriately denied medications under the new Medicare drug plans.

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