Patients, Physicians Struggle With Part D Rollout


In most cases the quantity limits have no impact, he said, but it has caused confusion among patients and he has spent a lot of time explaining it.

States to Recoup Emergency Drug $

The federal government and private drug plan sponsors will reimburse states that have provided drug coverage to Medicare beneficiaries since the Medicare Part D prescription drug benefit went into effect on Jan. 1.

Twenty-five states and the District of Columbia have been paying for prescription drugs on an emergency basis for beneficiaries who are dually eligible for Medicare and Medicaid but have had difficulty getting their medications.

Starting on Jan. 1, people who were eligible for both Medicare and Medicaid had their drug coverage transferred from the states to a Medicare prescription drug plan.

At the end of January, officials at the Centers for Medicare and Medicaid Services announced that they would begin a demonstration project that will allow them to ensure that states are fully reimbursed for their costs from the first date that the state paid claims until Feb. 15.

The states will be reimbursed by the prescription drug plan sponsors for contracted costs, and Medicare will pay any remaining drug costs. CMS will reimburse states for their administrative costs.

The move came just days after a group of senators introduced legislation—the Medicare State Reimbursement Act (S. 2181)—that would require the federal government to reimburse states for all of their costs plus interest.

Sen. Frank R. Lautenberg (D-N.J.), the chief sponsor of the legislation, said the CMS plan does not change the need for legislation.

“This is no solution,” he said in a statement. “It is simply more red tape from the Bush Administration.”

Sen. Lautenberg said the CMS plan will put a greater burden on the states by forcing them to act as bill collectors.


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