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State politicians are scrambling to make sure Medicaid patients are covered during the transition.On Friday, two weeks after the federal Medicare prescription drug benefit took effect on Jan. 1, state Assembly Democrats introduced a bill that would have the state Medicaid program pay drug claims for eligible seniors who could not fill their prescriptions through the Medicare benefit. The bill echos similar moves by other states across the country.More than a third of the members of the Assembly, including 12 Democrats from Queens, have signed on to the bill, which they called "emergency legislation." Although there was no Senate version at the time, Senate leaders were discussing the bill in a conference Tuesday.At the same time, Republican Gov. George Pataki Friday directed the state Health Department to allow Medicaid to cover the cost of prescription drugs for seven days through Jan. 20. Pataki's directive and the Assembly bill would have the state seek reimbursement from the federal government for the drug costs.Both plans apply only to the "dual-eligible" group who receive benefits from both Medicaid and Medicare. Medicaid is a federal health insurance program administered by the state for people of low income. Medicare is a strictly federal health benefit for senior citizens and disabled people. In New York state, 600,000 people qualify for both, Assembly members said, citing numbers tracked by the Kaiser Family Foundation.The Medicare prescription drug benefit, the Bush administration's most sweeping health care initiative, is designed to give seniors drug coverage through plans administered by private companies. Those who until the end of 2005 had drug coverage through Medicaid were placed into private Medicare drug plans-.President Bush this week ordered insurers to provide 30-day supplies of drugs that patients were previously taking, but state and Congressional Democrats have criticized the new plan."No one should have to go without medication, especially low-income seniors," Assemblyman Mark Weprin (D-Little Neck) said in a statement. "The new federal drug benefit was poorly conceived and disastrously implemented. I urge the governor and the Senate to work with the Assembly to provide immediate relief to ensure that no one falls through the cracks," he said.But advocates for seniors said the problems with the new law are systemic, not simply a few people falling through the cracks.Valerie Bogart, the director of legal resources at Selfhelp Community Services, a citywide senior homecare provider, said helping clients navigate the maze of new plans-there are 15 in New York-was "a total disaster.""We have so many clients we can't reach," she said. "We have a thousand people living in senior housing in Queens. At one of our senior centers in Flushing we have we think about 400 dual-eligible seniors, who all speak various Chinese dialects.""We've already heard of people walking out of the pharmacy without their drugs," she said.In addition, Bogart said, drug co-payments that were capped at $200 annually under Medicaid can be substantially higher under the Medicare prescription plans. Because each plan has a different set of drugs that are covered, patients who do not choose the right plan may not be insured for the medications they need.She also said Pataki's stop-gap measure was insufficient."Seven days is a joke," she said. "Pharmacists have to know to bill Medicaid. That takes a week to get the word out."Pataki said in a statement that the state would "continually reassess our options" to make sure patients get their prescriptions filled.Reach reporter John Tozzi by e-mail at firstname.lastname@example.org or by phone at 718-229-0300 Ext. 188.
©2006 Community Newspaper Group
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