[QUAD-L] Fwd: We Got Your Back

[DAANOO]

FYI this will help you write a letter to HHS, Secretary Michael Levitt to urge him to think continue Medicaid for filling in gaps between Medicare and Medicaid. Dana

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Asclepios               

 

Your Weekly Medicare Consumer Advocacy Update

We Got Your Back

November 17, 2005 • Volume 5, Issue 46

 

When the ball drops in Times Square on New Year’s Day, 6.4 million poor people will lose the prescription drug coverage they now receive through Medicaid. Will they all get the Medicare drug coverage that they’re entitled to on January 1?

           

Michael Leavitt, the secretary of the Department of Health and Human Services (HHS) says the administration is “working” on contingency plans.

           

That’s not good enough.

 

And that’s why the Medicare Rights Center, along with groups from Maine to California, filed suit this week against Secretary Leavitt. The suit seeks to force the administration to ensure continuity of coverage for any person with Medicare set to lose Medicaid drug coverage on January 1.

 

Earlier this week the nonpartisan Government Accountability Office (GAO) gave a briefing to Senator Max Baucus of Montana, the ranking Democrat on the Senate Finance Committee and a major sponsor the 2003 Medicare Modernization Act that created the new Medicare drug benefit.

           

The GAO’s conclusion: Secretary Leavitt’s plans are “not adequate” to ensure that the oldest, sickest and most impoverished Americans will not lose access to the medicines they need come January 1st.

           

“Current contingency plans rely heavily on the ability and willingness of pharmacies to assist beneficiaries and on the ability of beneficiaries to take action on their own behalf to resolve problems,” the GAO found.

           

If even a fraction of this vulnerable population—people with both Medicare and Medicaid—fall through the cracks, they could lose access to medicines that keep them alive.

           

These 6.4 million Americans generally take multiple medications and have far greater health care needs than other people with Medicare. About one-third are disabled and nearly 40 percent have a cognitive or mental impairment. These are the Americans most at risk of being worse off as a result of the new drug program for people with Medicare. And they are least able to help themselves.

 

After the suit was filed early this week, the American Society of Consulting Pharmacists voted to join the MRC lawsuit, and Senator Jay Rockefeller, Democrat of West Virginia, called the suit “a necessary step” to force Secretary Leavitt to obey the law.

 

There is a disconnect between the truth and the Bush administration’s assurances that the transition will go smoothly and everyone will be fine. Not to worry, we’re told. It’s under control.

           

But it’s not. Human error is inevitable, and a massive transition of 6.4 million people from one program to a completely different, remarkably complex program will be full of mishaps.

           

Look what has happened already.

           

• People with Medicare and Medicaid were misinformed about which plans were available for full premium subsidies in the Medicare and You 2006 handbook sent out to 43 million people with Medicare.

           

• Thousands of mailings that were supposed to inform people with Medicare and Medicaid about the pending change in drug coverage were instead empty envelopes.

           

• Major data errors resulted in the Bush administration mistakenly enrolling tens of thousands of people in Illinois in drug plans. Those errors resulted in thousands of people receiving wrong information on the steps they need to take to get the drug coverage they need.

 

To be sure, the Centers for Medicare and Medicaid Services (CMS) staff is working long hours dealing with a myriad of problems, most of them stemming from the fact that private for-profit plans deliver the drug benefit.

 

But people whose lives depend on access to medicine need more than empty political promises and the best efforts of an overstrapped staff at CMS.

 

The administration should come to court with a transition plan that will work.

 

Taking that step is not an admission of failure for CMS. It is a guarantee of success.

                       

Click here to send a letter to HHS Secretary Michael Leavitt urging him to take responsibility for the Medicare drug benefit by using Medicaid as a fail-safe mechanism that will guarantee continued drug coverage for the people who need it.

 

 

Medical Record

 

The lawsuit filed to enjoin the end of Medicaid for people with both Medicare and Medicaid warns that “countless” numbers of poor men and women “will fall through the cracks of this massive program transition,” and these impoverished people will face the loss of medicines needed “to function or survive.” It also says that the characteristics of the people at risk—nearly 40 percent are cognitively impaired and only 39 percent have a high school diploma—will prevent up to a million poor older Americans from immediately mastering the complexity of the new Medicare drug benefit so they can maintain access to needed medicine (“Lawsuit Seeks Injunction to Protect Poorest Americans from ‘Calamitous Consequences’ of New Medicare Drug Program,” Medicare Rights Center, November 2005).

 

State Medicaid directors say that the time frame for moving “dual eligibles” (people with both Medicare and Medicaid) into Medicare drug plans poses major challenges. Some used the term “disaster” to describe the ambitious timetable and the likely outcome of its implementation. From their perspective as program administrators, they indicated that the time allotted to get dual eligibles into private Medicare drug plans is not sufficient, even without accounting for the time these men and women would need to learn how to use them (“Implications of the Medicare Modernization Act for States: Observations from a Focus Group Discussion with Medicaid Directors,” Kaiser Commission on Medicaid and the Uninsured, January 2005).

 

The amount of time allocated for the switch from Medicaid drug coverage to Medicare drug coverage for dual eligibles is not enough to ensure a smooth transition. The Medicare Payment Advisory Commission (MedPAC), an independent federal body that advises Congress on Medicare issues, notes that accomplishing the task of transitioning people from one drug plan to another in the private sector takes a minimum of six, and preferably, nine months (“Report to the Congress: New Approaches in Medicare,” Medicare Payment Advisory Commission, June 2004).

 

 

Fast Relief

 

The Medicare Rights Center, with support from the Brookdale Foundation, is offering an Rx hotline (877-RXHELP-0) for nonprofit professionals who serve people with Medicare.

 

If you need help understanding or explaining the new Medicare prescription drug benefit to your clients, call RxHelp, a national hotline dedicated for nonprofit professionals serving the Medicare population, operated from 10 a.m. to 6 p.m.

 

Dial 877-RXHELP-0 (877-794-3570) today!

 

 

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Don’t Let Your Suffering Go Unnoticed

Are you struggling to pay for your prescriptions drugs or get the health care you need? Work with the Medicare Rights Center to bring your story to the ears of policymakers, the press and the public in an effort to expose the shortcomings of the American health care system. To learn more about how to make your voice heard in the national Medicare debate, visit www.medicarerights.org/maincontenthiddenlives.html.

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Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly action alert designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.

 

Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare. A national nonprofit founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.

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