The New York State Senate has given final passage to an emergency bill to help thousands of low-income seniors and disabled New Yorkers that are dually eligible for both Medicare and Medicaid pay for medically necessary drugs that should have been paid for by Medicare's newly implemented prescription drug program.

"Enrollment information for many dual eligibles seeking to fill prescriptions cannot be found in the Center for Medicaid and Medicare Services'database, and many beneficiaries have been overcharged or found that important prescriptions are no longer covered," said Sen. Kemp Hannon, chairman of the health committee and bill co-sponsor.

On Friday, Jan. 13th, the Governor issued an Executive Order directing the State Department of Health to suspend current Medicaid rules for seven days and pay for prescription drugs for dual eligibles. He instructs the pharmacists to collect $1 for generic and $3 for non-preferred brand from dual eligibles prior to submitting a claim to Medicaid. On Monday, Jan. 23, the Governor extended the suspension of current Medicaid rules an additional seven days. He will carefully monitor the situation and continually reassess options to ensure to program is properly implemented.

This bill allows the Legislature to take it one step further in providing a safety net for New York's most vulnerable by requiring that New York's Medicaid program continue to pay for prescriptions drugs for Medicare Part D beneficiaries until the Commissioner declares operational problems associated with the implementation of Medicare Part D, resolved and that emergency coverage is no longer necessary. The bill also requires that the Commissioner establish an administrative process to effectively implement the temporary changes and that there shall be no local share for any medical assistance payments.

This legislation seeks reimbursement from the federal government and drug plans for any funds the State's Medicaid programs expends for prescription drugs that should have been covered by Medicare Part D.

In New York, officials estimate that over 128,000 low income beneficiaries are having difficulty in obtaining prescriptions and according to the New York Medicare Rights Center, hotline calls have increased by 400 percent over the last year and 3,000 have yet to be responded to. "New York is in concert with 20 other states and has risen to the challenge by quickly responding to this public health crisis to ensure these vulnerable individuals will continue to receive uninterrupted drug coverage" said Sen. Hannon. 1-26-06

© 2005 North Country Gazette