CDCAN REPORT 006-2006 GOV ISSUES ORDER FOR EMERGENCY DRUG COVERAGE.htm

CDCAN
CALIFORNIA DISABILITY COMMUNITY ACTION NETWORK
DISABILITY RIGHTS NEWS REPORT
#006-2006 January 12, 2006 Thursday
Connecting people with disabilities & seniors to rights and unified action
1225 8th Street Suite 480 - Sacramento, CA 95814 916/446-0013 Fax: 916/446-0026
Marty Omoto - director email: martyomoto@rcip.com website: www.cdcan.us

MEDICARE PART D DRUG PLAN CRISIS
* GOVERNOR ISSUES ORDER FOR EMERGENCY DRUG COVERAGE
* 1 MILLION PERSONS WITH DISABILITIES & SENIORS IMPACTED
* REPORTS OF GROWING CRISIS AND CONFUSION OVER NEW MEDICARE DRUG PLAN
* SPECIAL CDCAN TOWNHALL TELEMEETING ON ISSUE SET FOR 1/19 THU AT 1 PM

SACRAMENTO - Responding to a growing crisis caused by confusion and delays over the implementation of the new federal Medicare prescription drug plan, Gov. Arnold Schwarzenegger late this afternoon (Jan 12) issued an order that authorizes a 5 day temporary emergency drug coverage to nearly 1 million Californians who are are eligible for both Medi-Cal and Medicare but are unable to obtain needed medications. Dual eligibles include persons with developmental and other disabilities and seniors. Nearly every part of the State has reported major confusion and even panic over the problems in people with disabilities and seniors unable to get needed medications under the new drug plan. Democratic legislative leaders from both houses pledged to move quickly on emergency legislation to appropriate state funds to extend the emergency coverage another 10 days or longer. [NOTE: There will be a special CDCAN Disability Rights Townhall Telemeeting on this issue scheduled next week on Thursday, January 19 at 1:00 PM to 2:45 PM for persons who have questions or concerns about the Medicare Part D program or about the Governor's order for a temporary emergency drug program. ]

"I took emergency action to ensure seniors and disabled Californians get lifesaving medications they are in danger of losing because of significant problems with the new federal Medicare prescription drug program," said Gov. Schwarzenegger. "Prescription drug coverage for people on Medicare and Medi-Cal is a federal responsibility but under these extreme circumstances, I have ordered that the state temporarily pay for their drug coverage. While I am confident the federal government will resolve the problems with this transition, these people need our help now and we're going to be there for them. I am also calling on the federal government to reimburse California for the cost of this action because they are accountable for this program and for ensuring these vulnerable Californians have the prescription drugs they need."

California Health and Human Services Agency Secretary Kim Belshe, who oversees the Medi-Cal program for the state, hinted earlier this afternoon in the CDCAN DIsability Rights Townhall Telemeeting where she spoke that the Governor was going to take action on the issue. About 300 persons with developmental and other disabilities, families, workers, community organizations and other advocates from across the state participated in the Townhall Telemeeting, with several raising concerns about the problems in getting needed medications under the new Medicare program.

"In response to the problems our residents are having accessing the prescription drugs they need, Governor Schwarzenegger has decided to take bold action to provide temporary, emergency coverage of prescription drug benefits for the nearly one million Californians who are dually eligible for Medi-Cal and Medicare," said Secretary Kim Belshé later.

Advocates Praise Emergency Action - Harshly Criticize Federal Government Implementation
Advocates for persons with disabilities and seniors generally praised the action by the Governor and legislative leaders and harshly criticized the federal government implementation of the new drug plan proposed by the Bush Administration and passed last year by Congress. .
On January 1, 2006, the Medicare Modernization Act took effect, with the federal government taking over responsibility for prescription drug coverage for the nearly one million Californians dually eligible for Medi-Cal and Medicare. The transition of these individuals to federal Medicare plans in just one day resulted in an error rate of 20% according to information from the Department of Health Services, resulting in nearly 200,000 persons with disabilities and seniors who are not receiving the medications they need. In addition, dual eligibles and pharmacies facing problems and attempting to clarify eligibility and Medicare drug plan enrollment have experienced long waits while trying to obtain information from Medicare's overloaded phone lines.

WHAT THE GOVERNOR ORDERED
The Governor's ordered the following action:
* The Department of Health Services, which oversee the Medi-Cal program, will "immediately" implement a 5 day emergency program to pay for prescription drugs for the dually eligible Medi-Cal and Medicare recipients who have been unable to obtain those medications through their Medicare Part D coverage.
* The Legislature is scheduled to move quickly next week in passing emergency legislation - which the Governor promised he would sign - that would extend the coverage for an additional 10 days.
* The Governor's order indicated that, starting today (Jan 12), the State "will be the payer of last resort" regarding people who are dually eligible for Medi-Cal and Medicare and were unable to obtain their needed prescription drugs.
* The Governor will request reimbursement from the federal government to the State for the cost of this emergency program.

HOW TO RECEIVE REIMBURSEMENT FOR MEDICATION
* A pharmacy must certify that it was either unable to obtain necessary information from Medicare to submit a claim; OR it's claim was incorrectly denied; OR that the Medi-Cal/Medicare eligible recipient's deductible or co-payment was higher than the $1 to $5 amount set by Medicare

NEXT STEPS
* Legislature will move quickly early next week to pass emergency legislation to extend the 5 day emergency program to at least 15 days total. The Legislature is due to reconvene on Tuesday, January 17 (Monday is a federal and state holiday honoring Dr. Martin Luther King, Jr.)
* There will be a special CDCAN Disability Rights Townhall Telemeeting on this issue scheduled next week on Thursday, January 19 at 1:00 PM to 2:45 PM for persons who have questions or concerns about the Medicare Part D program or about the Governor's order for a temporary emergency drug program.

How To Receive CDCAN Capitol News Reports and Alerts
The California Disability Community Action Network is a non-partisan link to thousands of Californians with developmental and other disabilities, people with traumatic brain and other injures, seniors and their families, community organizations and providers, direct care and other workers, and other advocates. These action alerts and news reports is for all of them. If you would like to get on this distribution (and conversely, get off of it) please send an email with that request to: martyomoto@rcip.com OR sign up via the NEW CDCAN website at www.cdcan.us Sharing information is part of our organizing effort. Please feel free to forward or copy this (attribution is nice). We're all in this together!