Health officials concede ‘D’ woes

Health officials yesterday acknowledged a rocky start and fierce criticism over handling of the Medicare Part D drug benefit that went into effect Jan. 1 and said a nationwide effort is under way to correct the problems.

While recent data show nearly 24 million Medicare beneficiaries have prescription drug coverage, a number of senior citizens have gone without their medications because of Medicare errors.

“The bad news is there are some glitches in the system,” said Leslie Norwalk, deputy administrator for the Centers for Medicare and Medicaid Services, the federal agency in charge of the drug program.

Ms. Norwalk, speaking at a public forum yesterday in Washington, blamed most of the early problems on computer systems that connect Medicare, the public health insurance program for seniors and the disabled, with health insurers and pharmacists.

“There are at least five sources where information can go wrong,” Ms. Norwalk said, adding that CMS has sent “SWAT teams” to each state to help health insurers correct patient information errors.

Incorrect patient data have delayed many seniors from getting their Medicare drug cards or member numbers, which in turn has created more work for pharmacists, said Debra Garza, a director with Deerfield, Ill., pharmacy company Walgreen Co.

Pharmacists “are facing a mass of people without Medicare cards,” she said.

Without approval from their health plans, beneficiaries nationwide have been forced to get emergency drug supplies or pay full price for their drugs, said Vicki Gottlich, senior policy attorney for the Center for Medicare Advocacy Inc. in Willimantic, Conn.

But AARP, the D.C. advocacy group for seniors, said these technical issues are occurring on a less frequent basis.

“At this point, we’re seeing less incidents and the program running more smoothly than the beginning of the year,” said spokesman George Kelemen, who was not at the event.

Beneficiaries who are dual-eligible for Medicaid, the public health insurance program for the poor, and Medicare also have experienced coverage delays.

These patients were automatically enrolled in one of the 45 state health plans offered under the Medicare program. But patients who switched plans often were not updated in the computer systems, Ms. Norwalk said.

Karen Ignagni, president and chief executive of D.C. trade group America’s Health Insurance Plans, said health insurers were tracking and correcting any mismatched information.

Patients also reported not receiving letters from their health insurers about health plan options they would need to make once their emergency drug supply ran out, an audience member, who said she was frustrated with the program, told speakers at the event.

Ms. Norwalk promised to look into the situation, with Ms. Garza advising those patients to see their pharmacist at least three to five days before their supply of medication was used up to clear up any problems.

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