U.S. to Extend Emergency Rx Coverage
By Kevin Freking
Associated Press

WASHINGTON -- Private insurers offering prescription drug coverage through Medicare should supply senior citizens with an additional 60-day supply of medicine for emergency cases, the Bush administration says.

The move will give beneficiaries more time to find alternative treatments when their plan won't cover a prescription, or more time to file an appeal. Pharmacists had warned that the previous 30-day limit could pose significant problems for poor senior citizens and disabled patients.

The new prescription drug program under Medicare began Jan. 1. In a review of the first month, Health and Human Services Secretary Mike Leavitt acknowledged there were problems with the startup. "I make no excuses," he said. "We own the problems."

He also said, however, that the new benefit is working for the vast majority of senior citizens, and competition among the private plans was leading to lower costs for the program.

Premiums for consumers will average about $25 a month, as opposed to the $37 that was projected when the program was approved. The lower costs also extend to taxpayers. The Centers for Medicare and Medicaid Services now estimate the program will cost about $678 billion over 10 years rather than about $730 billion.

"We're seeing the cost of drugs come down in a rapid way because of an organized, competitive marketplace," Leavitt said.

About 42 million senior citizens and disabled people are eligible to participate in the drug benefit. They do so by enrolling in a private insurance plan. The benefit should lower drug costs for most participants because the government is subsidizing their drug costs.

Lawmakers have scheduled hearings concerning the drug benefit and have filed an array of bills that they say are designed to improve the program.

Numerous lawmakers have said they have received scores of complaints about how confusing the program is, and how difficult it is for some of their constituents to get their medicine.

Dozens of states have stepped in. They are temporarily paying for medicine that senior citizens and disabled people have been unable to get through Medicare.

In his report, however, Leavitt said the drug benefit works for most people. He said a woman he met in Oklahoma City last week told him she would save about $3,000 this year.

"Dorothy was so delighted that she gave me a kiss and a high-five," Leavitt said. "She told a television reporter that she had lots of ways to use the money."

Last week, though, trade associations representing pharmacists, psychiatrists and nursing home directors said policy changes were urgently needed to help long-term care residents.

The groups said current policies can conflict with good clinical care, and the bureaucratic workload imposed on doctors and pharmacists will soon create an unsustainable impediment to serving nursing home residents.

February 2, 2006