Dealing with Medicare’s drug plan complications

The Times’ article “Advocates Call for Medicare Prescription Fixes” (Feb. 16) fails to note that the Centers for Medicare and Medicaid Services, or CMS, has taken a number of steps to ensure that those with severe disabilities who are eligible for both Medicare and Medicaid do not face gaps in coverage for critically important prescriptions. These include requirements for Medicare drug plans to cover all medications in this initial transition period and that the plans cover all drugs to treat conditions such as mental illness and epilepsy. The CMS has worked closely with organizations representing people with disabilities to ensure that these requirements are followed and beneficiaries get access to medications without interruption.

ANDREW SPERLING

Director of Legislative Advocacy

National Alliance on Mental Illness

Arlington, Va.

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When the federal government began to release the regulations for the Medicare prescription drug program, the California Board of Pharmacy created a special subcommittee to hear testimony from interested parties. Months before the program began on Jan. 1, panel members heard different stories from each stakeholder, ranging from the contention of the CMS that everything was going great to confusion and uncertainty from pharmacists.

As the program rolled out, it was clear that even its severest critics were shocked at the enormity of the problems that emerged. A recent survey of 500 California pharmacists showed that more than 70% were still having problems identifying the plans of the patients, 80% were having problems processing claims and 90% were having problems contacting the HMOs and insurance plans. The result is wholly inadequate care for patients.

The many pharmacists who stepped forward to assist patients with their medicines with no assurance of payment are to be commended, as is the state for coming forward with the emergency legislation to support patients’ medicine needs until the problems with this federal program are resolved. We call on Congress to make significant changes to this much-needed program, which is much too complex and too heavily weighted to the benefit of the plans and pharmaceutical firms. Such corrective action should come soon.

STANLEY GOLDENBERG

President

WILLIAM POWERS

Vice President

California Board of Pharmacy

Sacramento