The Detroit Free Press is today reporting that:

Leavitt said Medicare would notify the private drug plans administering the new Medicare drug benefit that they need to extend that emergency coverage for 60 more days.

“In effect, this means that plans will provide up to 90 days of coverage for a beneficiary’s current drugs,” HHS reports.

However, the additional supply of rx’s is, in theory, supposed to last a person until he/she completes the appeals process if the rx that their dr. prescribes is not covered under one of the formularies/plans.


Mary Johnson, executive director for the Michigan Medicare Medicaid Assistance Program, said she has had difficulty verifying the status of drug appeals for patients.

Pharmacist Ibrahim Chami, owner of Detroit Pharmacy, said he expected that patients would experience problems with only 30 days to appeal.  With the difficulty re:  the status of the appeals, would an additional 60 days make that much of a difference?

Chami also stated,

“With my customers, I tried to explain it…But I know there are people out there that don’t have someone to explain it to them.”

In addition, the Center for Medicare Advocacy Inc. reports that many patients have had difficulty getting Medicare drug plans to fill the original 30-day prescriptions to begin with.

“Even when beneficiaries are able to secure a transitional supply of medications,” the center wrote in a weekly e-mail alert, “they are not being told that they must take further action to get their medications” (when the emergency supply runs out).

So, all a person can do is file an appeal, if he/she is aware of the appeals process to begin with, or, switch their rx’s and there may not be a (generic) equivilant that fulfills one’s medical need!

And, there is more:

Gov. George Pataki said Friday he was vetoing a bill that would have indefinitely given New Yorkers access to medications if they are denied coverage under the new Medicare prescription drug benefit…Pataki, a Republican, enacted a temporary measure Jan. 13 directing the state Health Department to allow access to the drugs for seniors eligible for Medicare and Medicaid. The legislation would have permanently extended the measure until problems with the Medicare benefit that launched Jan. 1 were completely resolved.

Still more:

Officials from California, Kentucky and other states say they are being asked to reimburse Medicare for more than they are saving…

California Attorney General Bill Lockyer said Wednesday that his state would join several others in a lawsuit to ask the Supreme Court to halt the payment requirement. Republican Gov. Arnold Schwarzenegger said he supports the expected suit.

Kentucky Attorney General Greg Stumbo said Thursday that the case will be filed by March 1.

His state will have to pay the federal government $20 million more a year than it previously spent on drugs for its Medicaid beneficiaries, he said.

Kathy Walt, a spokeswoman for Texas Gov. Rick Perry, said the state is considering a number of options, including a lawsuit.

Despite earlier claims re:  lower drug costs, Rep. Henry Waxman, D-Calif., said,

Medicare officials had lost credibility. “They tell us that prices are amazingly low when seniors can see with their own eyes that that isn’t the case.”

According to Sen. Herb Kohl, D-Wis.,

basing multiyear estimates for a complex program on one month’s data was “ludicrous.”


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