Reminders Sent on Medicare Refills

Amid widespread confusion over the federal government’s new prescription drug plan, the Bush administration has sent out an advisory reminding drugstores of a requirement to provide a 30-day supply of the medications their customers got in December.

Thousands of Medicare beneficiaries have had difficulty getting prescriptions filled since the program took effect Jan. 1.

Last week, California joined several states in ordering emergency action to address the glitches and ensure that needed drugs were dispensed.

Jeff Flick, the western regional administrator for the federal agency that runs Medicare, said in an interview Sunday that the administration acted to reinforce the so-called first-fill requirement in a notice to insurers and in conference calls with pharmacists.

In a beneficiary’s first month in the drug program, private insurance plans that manage the new benefits are required to cover a 30-day supply of the prescriptions the beneficiary received the month before, he said.

“The idea behind this is, we wanted to be sure that whatever they were taking in December, they can get in January,” Flick said.

“Once they have that first fill, now they have 30 days to talk it over with their doctor. The point is, everybody has time for this transition.”

One problem with the rollout of the new plan is that many pharmacists were not aware of the first-fill requirement and were sending beneficiaries away without a 30-day supply, Flick said.

“There was a bit of confusion about that,” he said.

“Some of the pharmacies didn’t understand. So we gave guidance to all of the [drug] plans to please make sure all of the pharmacies that you contract with understand the first-fill commitment.”

Flick said Medicare administrators also reminded pharmacists that copays for low-income beneficiaries are capped at $5.

The reminders are among the administration’s steps to improve program implementation. Criticism has been mounting over widespread reports that beneficiaries, many of them poor and medically fragile, have not been able to get needed prescriptions filled.

Medicare databases were not updated with people who had signed up at the end of December. As a result, some beneficiaries had trouble getting medications -- or were mistakenly told they owed hundreds of dollars for them -- because pharmacists could not find them on enrollment lists.

Late Thursday, Medicare administrators sent insurers eligibility updates that included people who signed up at the end of December.

On Friday, Mark McClellan, administrator for the Centers for Medicare and Medicaid Services, acknowledged the problems with the drug plan and said the government was working on them.

“I’m working with the states, with the plans, with all of our partners to make sure people get the prescriptions they need,” he said in an interview with Associated Press.