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Pharmacists report some problems as new Medicare drug benefit begins

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Volunteer Rebecca Cox (R) helps a man log perscription drug information as he registers his parents for the new Medicare drug prescription program during a Medicare enrollment event December 19, 2005 in Pleasanton, California. Open enrollment for the new program began November 15 and will continue through May 15, 2006. (Photo by Justin Sullivan/Getty Images)
Several Minnesota pharmacists say they're having some trouble with the new Medicare Part D drug benefit, which started on Sunday. The program provides drug coverage to anyone enrolled in Medicare, the health insurance program for seniors. Pharmacists say they can't fill some patients' orders because of computer or paperwork problems. They also say some customers have been reluctant to enroll in the program because it's too confusing.

St. Paul, Minn. — Officials with the Minnesota Pharmacists Association say things are going smoothly when customers have confirmation that they're enrolled in the new drug program. But even though the new drug benefit is barely two days old, problems have popped up for a small number of people with no proof of coverage. John Stevens is a pharmacist at the Thrifty White Drug Store in Red Wing and is president of the Minnesota Pharmacists Association.

"This thing has come up so fast. It's been a freight train running down the tracks with no brakes," Stevens said.

Stevens says the computer system that is supposed to confirm that a patient is covered under the new drug program has been backed up and information isn't up to date. In addition, many patients don't have an identification card or letter confirming they're enrolled in one of the many privately run plans that administer the program. Combine those two problems and Stevens says the pharmacy has no way of knowing if the affected customers are covered. As a result, he's been forced to charge them full price for their medications.

"We either sell them a few pills, or, depending on their situation we sell them a complete prescription and process it at a later date and refund it to them," Stevens said. "We're trying to accommodate everybody's health care needs. We're not going to let anybody go without their important medications," he said.

Stevens is confident that the Centers for Medicare and Medicaid Services will correct the problem in a few days. In the meantime, he's encouraging customers to be patient or hold off on placing their orders unless it's absolutely necessary. The prescription drug benefit, known as Medicare Part D, started on the first of the year. Twenty two million Americans had signed up for the benefit by mid-December. Basically, the program gives drug coverage to people on Medicare, which the government has never provided before.

Many people throw up their hands in confusion and fear because of the complexity of the plan that lies before them.
- Cheryl Halvorson, MeritCare pharmacist

The process has been confusing for some seniors. Cheryl Halvorson is a pharmacist for MeritCare in Fargo. She says some of her customers have had trouble navigating through the dozens of available plans.

"Many people throw up their hands in confusion and fear because of the complexity of the plan that lies before them," Halvorson said.

Despite the early problems, Halvorson is confident the program will be beneficial. The private companies administering the program offer a range of plans that differ on price and available drugs. She's encouraging her customers to consider each plan carefully.

Pete Wyckoff with the Minnesota Senior Federation says counselors with his organization, the Senior Linkage Line and Medicare have been helping seniors navigate the system. He says people should be patient and wait until they find the best plan for their needs.

"For the vast majority of people, there is no reason to either panic or rush," Wyckoff said. We have until at least May 15th before any real decisions need to be made," he said.

Wycoff says seniors who enroll after May 15th will have to pay higher premium costs to enroll in the program. While Wycoff is encouraging seniors to consider their options, he's troubled that Medicare is expecting seniors to use the Internet to study the different drug plans. He called it a daunting task for seniors with little or no computer experience. He also says seniors should expect long waits at the pharmacy as the initial problems get ironed out.

Bob Herskovitz, with the Centers for Medicare and Medicaid Services, says his office has not seen too many problems during the first days of the program even though he expects some glitches in the first few weeks. He says pharmacists should notify his agency if they're having problems processing orders.

"The pharmacists do have a pipeline to communicate with medicare," Herskovitz said. "If they come across an issue or come across a hypothetical issue, that they think 'Hey, did you think of this or did you think of that?' They should pick up the phone and let us know."

Herskovitz called the new drug benefit the most significant advance in Medicare's 40-year history. He says the program is too important for many seniors to forego because of confusion, especially since, in some instances, seniors could cut their drug costs in half.

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