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Rocky Transition to the Medicare Drug Program

by Medindia Content Team on Mar 1 2006 3:56 PM

Medicare program chief said that U.S. government plans to reimburse funds spent on poor elderly and disabled Americans. Mark McClellan, director of the Centers for Medicare and Medicaid Services, told a National Governors Association conference the government would make procedures for the states to file reimbursement claims for Medicaid recipients unable to obtain drugs under the new Medicare Part D Program.

It also plans to switch dual eligibles to the private drug plan providers. But thousands were unable obtain their prescriptions because of enrollment problems or computer glitches.

More than 40 states stepped in to pay for drugs which would easily reach billions of dollars for these people under old Medicaid drug programs. New Jersey Gov. John Corzine said that his state has already spent nearly $50 million for the Medicare Part D program. According to the Kaiser Family Foundation, New York had spent $80 million to cover dual eligibles.

McClellan asked the states to send in the claims for which they would send back the payments within about four weeks. This would ensure that the people would receive clean claims from the states. This reduces the states interaction with the health plans.

But he also mentioned the increase in cost during reimbursements that would be felt by the federal government apart from the cost of the Medicare Part D program. The reason for additional cost is that most state Medicare programs have higher pharmacy payment rates.

McClellan also said that state Medicaid programs were paying for significantly fewer prescriptions for elderly and disabled Medicaid recipients.


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