[Winona Online Democracy]

The article below reflects what is also happening in Winona this week.  We
can do nothing about Part D locally and the pharmacists are being put in a
terrible position of financial risk.  There are low income, frail people
needing life saving medications who are being told they are supposed to pay
$250 first -- all because of a mess created at the Federal level with this
Medicare Part D.  I am sure our local Pharmacists will do everything they
can to avoid denial of necessary medications.  But they can not be expected
to continue a cash flow problem that will cost them easily over a hundred
thousand a week for a small operation.  If you know anyone who is having
trouble with this problem, please help them work something out with their
Pharmacist.  AND, please contact Gutnecht and Coleman.
I hope I am wrong - but I expect this is NOT just a little glitch at the
beginning of a new program.  I suspect this is a major problem where we are
just now seeing the tip of the iceberg.  Personally, I believe Part D was
intended by its creators to benefit drug companies and HMOs with little, if
any, regard for the local druggist or especially for the poor recipients who
need the medications.
This system is so complex and expensive and harmful it is beyond words.  We
must work to change this mess but in the meantime we need to help those who
might be forced to go without necessary medications person by person.

Craig Brooks

<(©¿©)>

*************
Last update: January 06, 2006 – 12:50 AM
Medicare flaw denies drugs for some poor
Officials are worried that many poor people may not be getting medicines
they need.

Warren Wolfe, Star Tribune
Laura Monson, 65, is staying close to her subsidized apartment in
Minneapolis, severe leg pains restricting her movement, because her
pharmacist would not refill a prescription -- one of 11 drugs that have run
out.

Hundreds and maybe thousands of poor Medicare beneficiaries like Monson have
been turned away from drugstores this week because of a major flaw in
implementing the program's new drug benefit, state officials said Thursday.
The problem is that the Medicare computer is telling pharmacists that these
beneficiaries are enrolled in a drug plan, but it's not confirming that
their poverty qualifies them for nearly free drugs.

State officials became so concerned that they directed the state's
already-jammed Minnesota Linkage Line to drop nearly all other work and try
to resolve the problems.

"I'm not a doctor, but I know it's not a good thing to go without your
medications," said Jim Varpness, head of the Minnesota Board on Aging, which
operates the Linkage Line.

"It could be very, very bad," Varpness said.

Not all poor people in that category -- dually eligible for Medicare and
Medicaid -- are having problems. Many are getting their drugs, some from
their regular pharmacists, who know them and take on faith that the problem
will be fixed.

While spotty problems have been reported in other states, Medicare officials
said they appear to getting more complaints from Minnesota.

'Dual-eligibles' at risk

The biggest problem is among "dual eligible" people who are on both Medicare
and Medicaid.

They typically take more drugs and are in more frail health than other
Medicare beneficiaries, Varpness said.

Until Jan. 1, their drugs were paid for by Medicaid. Under the new Medicare
law, those costs are being paid by one of about two dozen heavily subsidized
Medicaid drug plans operated by private insurers.

To make sure there would be no break in coverage, all 6.2 million of them --
95,000 in Minnesota -- were automatically assigned by Medicare to drug plans
chosen at random.

But starting Sunday, when the new benefit took effect, pharmacists found
that many of them were listed on a Medicare computer database as being
enrolled, but not as eligible for the subsidized portion of the plan.

The subsidy allows them to pay between $1 and $5 per prescription, with no
deductible and no monthly insurance premium.

In other cases, either Medicare or the private insurance companies appear to
have made errors in enrolling people. In addition, an overwhelmed Medicare
is simply behind in verifying that people who enrolled in plans actually
qualify.

In a national conference call with pharmacists Thursday morning, Medicare
pleaded with drugstores to dispense drugs to those on Medicare and Medicaid
and to assume that the problems will be resolved soon. But Medicare
officials acknowledged that they could not compel pharmacists to do so.

At the Minnesota Pharmacists Association, "We're hearing about pockets of
problems with dual-eligibles, but I'm hoping they're subsiding," said
executive vice president Julie Johnson. "Pharmacists are not the bad guys
here. They are spending a lot of time trying to help their customers."

Problems have popped up at Astrup Drug, an 11-store chain of pharmacies in
southern Minnesota, pharmacy manager Tim Gallagher said.

"But we're not sending anybody away," he said. "If we can see that they're a
dual-eligible, they get their prescriptions no matter what the Medicare
computer says."

Help from Linkage Line

The Linkage Line was already getting 7,000 calls a week about the new
benefit plan before the problem with dual eligibility surfaced.

"We've had about 70 calls Tuesday and Wednesday from beneficiaries with this
problem," the Board of Aging's Varpness said. By Thursday afternoon, two
were "close to being resolved," he said.

"If that many got through when we can't even answer all the calls we're
getting, how many didn't get through?" he said. "How many didn't even know
to call us?"

He urged all dually eligible beneficiaries having trouble with the Medicare
drug benefit to call the Linkage Line, 1-800-333-2433.

"These are poor people who are being told they have to pay a $250
deductible, and then pay the full price for the drugs," said Rhonda
Peterson, a social worker with the nonprofit agency Volunteers of America
who works in a Minneapolis senior high-rise. "They just can't do that. Many
are just going without drugs they need."

She's trying to help several clients, including Monson, who are having
problems with the Medicare benefit.

Peterson said she thinks she may have convinced Monson's pharmacist to
dispense her drugs for this month and await confirmation that she's eligible
for the subsidy.

"You know, this really isn't right," Monson said. "It's kind of frightening
when you don't know what's happening with your medications."

Warren Wolfe • 612-673-7253


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