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Health Care Reform:

Health Insurance & Affordable Care Act

But Health Official Says Next Month Could Bring New Woes for Drug Benefit

WebMD Health News

Government: Medicare Snafus Improving

Jan. 24, 2006 -- Bush administration officials said Tuesday that problems plaguing the first month of the Medicare prescription benefit are improving but warned patients and health providers to brace for more.

Hundreds of thousands of patients using their Medicare drug benefits for the first time have reportedly been unable to fill needed prescriptions at pharmacies. The problems have affected mostly poorer patients who previously used Medicaid to obtain medicines but were switched to the new Medicare program on Jan. 1.

Most of the problems were caused by poorly updated computer systems that did not contain beneficiaries' files when they went to buy medicines. Pharmacists and patients who ran into trouble were confronted with long waits as call centers run by private Medicare drug plans were overwhelmed with requests for help.

Emergency Aid

The breakdowns forced 22 states and the District of Columbia to step in with emergency aid to cover beneficiaries' drug costs.

They also sent federal officials scrambling to unravel problems affecting 600,000 or more beneficiaries.

Health and Human Services Secretary Michael O. Leavitt described the transition for the new benefit, which is less than a month old, as having "still plenty of bumps, but much better" than it was last week.

He said that health plan call centers have improved their wait times and that government and health plan computers are communicating more effectively with terminals pharmacists use to verify patients' benefits before dispensing medicines.

"We are taking it seriously and we are doing everything we can," he told reporters Tuesday.

Leavitt this week completed an eight-state trip during which federal officials met with state officials and health providers confronting problems implementing the new benefit. He is set to leave Wednesday to visit seven more states.

New Problems Anticipated

But Leavitt also repeated warnings that despite government efforts, problems could re-emerge after plans and pharmacies start a new billing cycle Feb. 1. Patients who enroll in drug plans at the end of this month could find that pharmacy computers don't contain their files early next month.

"We anticipate that there will be problems on Feb. 1 with people who enrolled or switched their plans late in the month," he said.

Leavitt urged seniors signing up for a drug plan or switching to a new plan from an assigned Medicare plan to do so early in the month. "The sooner you do it in the month, the more likely it is that the system will reflect that change when you go to the pharmacy counter at the end of the month," he said.

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