Maine will keep buying drugs for thousands of elderly and disabled people accidentally shut out of the new Medicare prescription program.
The federal government is adamant that the “safety net” is not necessary.
But the state says it’s getting at least 500 calls a day from people who need their medications and aren’t getting them through the beleaguered federal drug program.
“The governor says this is a priority. It’s important people not get turned away,” said Jude Walsh, head of prescription drug programs for the Governor’s Office of Health Policy and Finance.
Gov. John Baldacci’s decision comes one day after Maine announced plans to pull the safety net because the federal government refused to reimburse for money spent after March 31.
The state’s drug payments were scheduled to stop on Thursday. Baldacci has ordered them to continue and has told Walsh to set up a task force that will start meeting Friday. The task force, comprising pharmacists, insurance professionals and others, will try to come up with a plan to ensure that people get their medications. It will also calculate the costs involved.
Maine has been paying for drugs since early January, when the new Medicare Part D floundered under a tide of computer glitches and registration problems. At one point, the state was spending $100,000 a day to pay for drugs that should have been covered under the federal plan.
Federal officials agreed to reimburse Maine for that safety net, but only through Feb. 15. Maine asked for and won extensions to pay for prescriptions through March 31.
But when Baldacci recently asked for another extension through the end of April, the federal government said no, there wasn’t a need.
A federal spokeswoman said the Medicare system is now running well.
Walsh agrees that problems have dropped dramatically. But she said Maine continues to pay for thousands of people accidentally locked out of the Medicare program. Last Thursday and Friday, the state helped nearly 1,200 people with 1,755 drugs.
Adding to the potential problem: On April 15, anyone enrolled in two Medicare Part D drug plans will be automatically pulled out of one by the federal government. That will affect 20,000 Mainers, and Walsh worries that some will be wrongly kicked out of the one prescription plan they’ve found useful.
Without the safety net, Mainers could have called the state hot line if they had a problem. But they likely would have been directed to federal personnel.
“He (Baldacci) said it’s just not good enough to give a 1-800-Medicare number. We made commitments to Maine people,” Walsh said.
Started on Jan. 1, Medicare Part D was supposed to be an easy way for the country’s elderly and disabled to get low-cost medications, but problems arose within days. Some people weren’t in the computer system, even though they had proof they were enrolled in the new drug program. Some were told they had a plan, but it didn’t cover the medications they needed. Others got a plan and their drugs but were charged up to $100 when they had expected a $1 co-pay.
On Jan. 3, the state held an emergency conference call with pharmacists and told them to fill all prescriptions. The state promised payment, calling it a “safety net.” Other states and cities soon followed.
Maine has not yet been reimbursed for the $5 million it’s spent on drugs so far, according to Walsh.