Monday, June 25, 2018
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Politicians turning up the heat over Medicare glitches

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Gov. Pawlenty decided over the weekend that the state will pay for prescription drugs for low-income Minnesotans who have not been able to get their drugs through Medicare Part D because of a computer glitch. Many other states have taken the same step. (MPR file photo)
Over the weekend, the state and federal governments took steps to address some of the problems plaguing the new Medicare prescription drug benefit. Pharmacists have been complaining that the system has been confusing and backed up. Among the problems, Minnesotans on low incomes have been unable to afford their medicine because of glitches in the system.

St. Paul, Minn. — It's been a rough couple of weeks at the Thrifty Drug Store in Red Wing, ever since the Medicare prescription drug program went into effect. Pharmacist John Stevens says he's been providing prescriptions to customers, even though he's not sure they're covered under the program.

Stevens says many customers show up with the right paperwork and are getting their medicine. The problem is with the group of people who don't have paperwork or who have been enrolled in the wrong plan.

"Every time someone comes in and doesn't have an ID card or an acknowledgment letter, we spend 15, 20 minutes or a half an hour on them. Well, of course, that just backs up everybody else at the counter," says Stevens.

The prescription drug benefit, also known as Medicare Part D, has been hailed as the biggest expansion in Medicare's 40-year history. Elderly and disabled Americans are eligible for drug coverage through private health insurance plans.

The problem is that each plan is different. That means pharmacists have to work the phones and the computers to figure out which program a customer is enrolled in.

Stevens is the president of the Minnesota Pharmacists Association. He says he's spoken with dozens of pharmacists who have had trouble determining eligibility for patients, because Medicare's master list is out of date or the computer system is backed up.

Stevens says many pharmacists have filled the prescriptions with the hopes that they'll be reimbursed someday.

"They've put out thousands of dollars worth of prescriptions, based on the fact that we're pretty sure we're going to be paid sometime. To avoid any health care issues, pharmacists have extended credit or let medications go out," Stevens says.

With these latest corrective actions, we're pretty hopeful that all beneficiaries should get their prescriptions filled.
- Jackie Garner, Centers for Medicare and Medicaid Services

The other problem with the program is that Medicare's computer system shows that some of the poorest and sickest Minnesotans aren't enrolled in a program, or don't receive the expected discounts.

Some 95,000 Minnesotans were supposed to get their drug coverage transferred from the state-run Medicaid program to the Medicare-subsidized private insurance plans on Jan. 1.

On Saturday, Gov. Pawlenty issued a five-day emergency executive order saying the state would step in and cover the costs for those low-income Minnesotans who are affected by the glitch. Stevens worries the problem will take longer than five days to fix.

Jackie Garner with the Centers for Medicare and Medicaid Services says the problem was caused by a mixup in computer records. She's optimistic that the problems will be fixed by the end of the week.

"One person not getting their drugs is one person too many. That's unacceptable," Garner says. "But with these latest corrective actions, we're pretty hopeful that all beneficiaries should get their prescriptions filled."

Garner says the private insurance companies, not the federal government, will have to reimburse Minnesota for any of the costs it spent on the affected Minnesotans. Garner also emphasized that the program is working for many Medicare recipients. She says Medicare is covering about one million prescriptions per day.

Nevertheless, many members of Congress haven't been happy with how the program has been administered.

U.S. Sen. Norm Coleman, R-Minn., says many politicians are unhappy with how the Centers for Medicare and Medicaid Services have handled the new benefit.

"People should not be in a position where they're not able to get their medicine. That's totally contrary to the whole concept here," Coleman says. "I was very angry about the way it was implemented, this piece of it. But I'm very hopeful that because voices have been raised and the pressure has been put on, that they'll take care of it very quickly."

Coleman says the Senate intends to hold hearings in early February on the issue.