6.4
million Americans at risk of “catastrophic human consequences”
caused by Medicare Drug transition
New York, NY –
When 6.4 million Americans are transitioned from Medicaid to
Medicare prescription drug coverage on January 1, 2006, foreseeable
gaps in drug coverage could have “catastrophic human consequences,”
according to a new report by the Medicare Rights Center.
“The poorest,
sickest, and oldest Americans face grave risk of losing their
life-saving medications once the clock strikes twelve on New
Year’s,” said Robert M. Hayes, president of the Medicare Rights
Center, a national consumer service group.
“President Bush
must ask Congress to erect a safety net to avert this inevitable
harm to the frailest Americans. It should extend Medicaid drug
coverage during the perilous transition,” said Mr. Hayes.
People with both
Medicaid and Medicare, the “dual eligibles,” will be automatically
transferred into the hundreds of private companies offering Medicare
drug plans, leaving no room for computer or human error, warns the
consumer group in 6.4 Million at Risk:
Protecting the Poorest Americans During the Medicare Drug Transition.
Medicare drug coverage differs from
Medicaid drug coverage in regards to the specific drugs that are
covered, the pharmacies that accept the coverage, and the
availability of emergency supplies pending appeals when plans deny
coverage of prescribed medications.
The reportidentifies serious risks the
transition poses such as people falling through the cracks of
complicated data exchanges between and among the Social Security
Administration, Centers for Medicaid and Medicare Services, drug
plans and states; losing coverage because of formulary and pharmacy
network limitations; and not understanding changes in their coverage
enough to navigate the complicated new system.
“Even if they get
it 95 percent right, over 300,000 of the frailest people with
Medicare won’t have access to their medications, resulting in more
hospitalizations, disease progression and premature death,” said Mr.
Hayes. “And, that’s being optimistic.”
The solution that
the Medicare Rights Center proposes is that Congress extends the
availability of Medicaid as a backup during a reasonable transition
to Medicare drug coverage.
The Medicare Rights
Center’s report 6.4 Million at Risk: Protecting the Poorest
Americans During the Medicare Drug Transition is available
online at
http://www.medicarerights.org/drugtransitionreport.pdf.
The report was produced by the law firm Manatt Phelps & Phillips in
consultation with the Medicare Rights Center.