Promoted from the diaries by Steven D with some minor edits.
According to an article in Forbes the problems w/Medicare D are now being shifted away from the “insurers” and is being placed on those who followed the advice that was given to them re: choosing a plan that would pay for all of their prescriptions!
Medicaid recipients….were auto-enrolled by the agency into a private Part D plan. But some also went ahead and chose another plan in the run-up to the Jan. 1 deadline. The result? Data regarding their choice of a private plan made it into the system, but information as to their ongoing status as an eligible Medicaid/Medicare recipient did not.
And, some switched to a different plan, trusting information given to them that the plan a person switched to would cover all of their prescriptions. However, this didn’t always happen, despite the fact that,
under Part D rules, the new plan was required to cover the drug for a 30-day period.
Bill Vaughn, a health lobbyist and senior policy analyst at Washington, D.C.-based Consumers Union (which publishes Consumer Reports) described the federal government’s rush to implement Medicare D as:
Vaughn further used a 2004 government study from the Medicare Payment Advisory Commission to illustrate his point. The study found that transferring an enormous number of files from one insurance carrier to another averages approximately SIX MONTHS
He then added:
“But here you have people in Part D signing up beginning on Nov. 15th for a program that starts Jan. 1 — with some people even signing up Dec. 31st. And you expect them to get a prescription by January 2nd? It just won’t work.”
Now from Medicare spokesman Peter Ashkenaz:
” Congress created the Part D program to begin January 1, 2006.”
Ashkenas also claims that the new system has a built-in:
“safety net…if a beneficiary is found not to be in a plan, the pharmacist has the ability to sign that ‘dual-eligible’ up to a plan right there at the counter …”
Robert Hayes, president of the Medicare Rights Center, states that he had a discussion with Mark McClellan, (Administrator of the federal Centers for Medicare and Medicaid Services) EARLY LAST YEAR:
“I was sitting in McClellan’s office and I said, ‘Look, even if you get this transition 99 percent right for the people losing Medicaid coverage, you’re still going to have 64,000 people without drug coverage come Jan. 1.’ And [McClellan] said ‘No, we have everything under control.’ “
However, according to New York City-based “information designer” Leslie Smolan, patient information remains split among the agency, doctors, pharmacies and insurance plans — each with its own computer system and “language,” as opposed to a centralized computer network/system that would allow all to share the same information/codes. Smolan also added that Medicare D should have had some:
“[B]eta testing…what any business creating any kind of product would do — make sure it works, then roll it out…Now, it’s just damage control.”