WASHINGTON (AP) -- Many elderly and disabled Americans enrolled in the
Medicare drug benefit will face new difficulties obtaining their
medicines on April 1st, say advocacy groups familiar with the program.
On that date, insurers will have more latitude to tell pharmacists
they won't pay for a particular drug. Before that, insurers have been
told they should pay for a prescription even if it's not on the list
of drugs they cover.
"I think that, after April 1st, you're going to see huge problems with
access. It's going to be January 1st all over again," said TomClark,
policy director at the American Society of Consultant Pharmacists. The
association represents pharmacists who serve nursing homes...
Vicki Gottlich, senior policy attorney for the Center for Medicare
Advocacy Inc., said she's concerned that the poorest of senior
citizens and the disabled would again have the most significant
problems on April 1st.
Often those beneficiaries were automatically enrolled in a drug plan,
and they will have no idea until next month that their medicine is not
covered. "To be honest, we've been talking to CMS, and I got the sense
they thought this was an issue," Gottlich said.
The Center for Medicare Advocacy has been critical of the drug
program. Gottlich said the organization has heard stories of clients
with numerous drugs not covered by their drug plans.
Another advocacy group that has criticized the program, the Medicare
Rights Center, said it's hearing complaints that people calling to
appeal coverage restrictions have been put on hold for more than an
hour. In other cases, customer service representatives promise to call
back, but never do.
"The plans make it difficult for patients and doctors to navigate the
appeals process," the group said.
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Just another Bush clusterfuck.
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