Pharmacists, Nursing Homes Prepare For Start Of Medicare Prescription Drug Benefit, USA

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pharmacy / Pharmacist
Article Date: 20 Dec 2005 - 11:00 PDT

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With the official start of the new Medicare prescription drug benefit less than two weeks away, pharmacists and nursing home operators are working to prepare elderly residents for the new coverage, the San Francisco Chronicle reports. According to the Long Term Care Pharmacy Alliance, the typical nursing home resident is age 84 and takes an average of nine medications. More than 70% of nursing home residents have some kind of cognitive impairment, such as dementia. As a result, many are not able to research and make "informed decisions" about their coverage options under the new Medicare drug benefit, the Chronicle reports. Nursing home operators are working to help residents understand the drug plans, but, because lawmakers were concerned that nursing homes would direct patients to plans that contract with preferred pharmacies, federal law prohibits them from choosing plans for residents.

Dual Eligibles
Facility operators also are working to determine coverage for the two-thirds of nursing home residents who are dually eligible for Medicare and Medicaid. Drug coverage for dual eligibles will transfer to Medicare Jan. 1, and CMS has randomly assigned all dual eligibles to a Medicare drug plan (Colliver, San Francisco Chronicle, 12/18). The Bush administration sent letters to dual eligibles informing them about the change in coverage. However, nursing home operators say that in many cases they do not know to which plans their patients have been assigned. Nursing homes can obtain the information by submitting queries to the CMS Web site or by sending a fax to CMS. CMS says it will send the information to nursing homes within 10 business days. Federal contractor NDCHealth is uploading the data to the CMS Web site, but a spokesperson for the company said it has not yet received all of the necessary information. CMS spokesperson Gary Karr said all of the information would be available before Dec. 31 (Pear, New York Times, 12/19).

Postal Service Denied Subsidy
In related news, federal officials have denied a request by the U.S. Postal Service to obtain a subsidy offered under the 2003 Medicare law to encourage employers to continue retiree drug coverage. USPS requested the subsidy, but officials denied the request because the agency participates in the Federal Employee Health Benefits Program, which is not taking the subsidy. In October, the Office of Personnel Management said it would forego the subsidy for civil service retirees because FEHBP benefits will not be reduced (Barr, Washington Post, 12/19).

Advice on Enrollment
The Wall Street Journal on Sunday published advice for beneficiaries enrolling in the Medicare drug benefit. Tips included using the online drug comparison tool at Medicare.gov, switching to generic drugs and using medications on preferred drugs lists (Lueck, Wall Street Journal, 12/18). CBS' "Evening News" on Friday reported on the Medicare prescription drug benefit enrollment process. The segment includes comments from Delana Hopkins, a counselor for Medicare; CMS Administrator Mark McClellan; Doug Norris, a manager with UnitedHealth Group; and Medicare beneficiaries (Andrews, "Evening News," CBS, 12/16). A transcript of the segment is available online. The complete segment is available online in RealPlayer.

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