McClellan says feds will reimburse states for dual-eligible costs attributable to Part D foul-ups
From the SF Chronicle:
Federal health officials assured the more than 20 states that have enacted emergency fixes that their costs will be covered.
Immediately after the Medicare drug benefit program began on Jan. 1, patients, pharmacists and health officials reported widespread cases of beneficiaries who were overcharged or forced to leave drugstores without their medications.
In response, many states stepped in to become “payers of last resort” for the most vulnerable population — Medicare beneficiaries who also receive coverage through the Medicaid program for the poor and disabled. Medicaid had been paying this group’s drug costs but transferred those patients into the new Medicare program, which is run by private companies.
“States that work with us to complete the transfer to (a Medicare drug plan) for their beneficiaries will be reimbursed,” said Dr. Mark McClellan, head of the Centers for Medicare and Medicaid Services, in a telephone news conference Tuesday.
Medicare officials have repeatedly said they will help the states work with insurers to get their money back. But health insurance officials have said the plans are obligated to provide reimbursements under the terms of their contracts and do not have to pay any additional expenses states may incur.
McClellan said the federal government will make sure states are reimbursed for their administrative expenditures plus cost differences between what the state and the health insurers pay for drugs.
“If the state reimbursement rates are higher than (the plans’ rates), Medicare will pay that difference in costs. The states are not going to have to go out and work with each drug plan on their own,” he said.
California Governor Arnold Schwarzenegger hailed the federal government’s commitment. “This is the right thing to do because Medicare is a federal program and it is the responsibility of the federal government not only to fix what is not working, but also to fully fund it,” the governor said in a statement.
Health and Human Services Secretary Michael Leavitt said Tuesday that Medicare has identified specific problems in the program that federal officials will make a top priority to resolve. They include data transmission errors and customer service inadequacies.
Still, Leavitt said the program is fixing its problems and meeting enrollment goals.
“It’s the biggest change to Medicare in 40 years. Anytime you make a change this big in a small amount of time there are bound to be some … problems,” he said. “Every day, the system is getting better.”