CDCAN REPORT 019-2006 Governor Signs Bill Extending Emergency Drug Coverage.htm

CDCAN
CALIFORNIA DISABILITY COMMUNITY ACTION NETWORK
DISABILITY RIGHTS NEWS REPORT
Remembering Charlotte Colton & Her Family
#0019-2006 February 9, 2006 Thursday
Advocacy Without Borders:
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 PROGRAM CRISIS
* GOV SIGNS BILL TO EXTEND EMERGENCY DRUG PROGRAM
* EXTENDS EMERGENCY PROGRAM FOR UP TO 90 DAYS
* THOUSANDS OF PEOPLE WITH DISABILITIES & SENIORS IMPACTED
* STATE URGES FEDERAL GOVERNMENT TO RESOLVE CRISIS
* FEDS RECALCULATE CALIFORNIA COST OF NEW PROGRAM

SACRAMENTO - In the midst of a continuing crisis, Gov. Arnold Schwarzenegger today signed emergency legislation, SB 1233 by Senate President Pro Tem Don Perata (D-Oakland) and co-authored by Senate Republican Leader Dick Ackerman (R-Irvine), Assembly Speaker Fabian Nuñez (D-Los Angeles) and Assembly Republican Leader Kevin McCarthy (R-Bakersfield), that extends the emergency prescription drug program for up to 90 days from February 15, to ensure that just over 1 million persons with developmental and other disabilities and seniors who are dually eligible for Medi-Cal and Medicare are able to obtain needed medications under the new federal Medicare Part D Drug Program. The bill goes into effect immediately and replaces AB 132 which expires on Feb. 15.

SB 1233 continues the emergency program the state originally established on January 12 through February 15. It then provides the Governor with the authority to extend it further with additional 30 day extensions each, but not beyond May 16, 2006 (unless new legislation extends it beyond that date).

In another development, the Federal government announced it was recalculating California's cost for the Medicare Part D program, with a result that the state will not spend more of its funds to implement the program for those who are dual eligible for both Medicare and Medi-Cal than it would have if Medi-Cal continued to provide drug coverage to those people, sometimes referred to as "the clawback". [see below for details].

The State Senate passed the bill on Monday (February 6) with almost full support from both parties, on a vote of 33-2, with only Republican State Senators Hollingsworth and McClintock opposing it. Senators Morrow, Scott, Soto and Speier either abstained or were not present. The Assembly passed the measure also with overwhelming support from both parties, 67-2. A full detailed CDCAN vote record report will be issued tomorrow (Friday, February 10).

Important Note: people and organizations impacted by this emergency drug coverage extension, including people with disabilities and seniors, their families, pharmacies, regional centers, community based organizations and others should pass on the information of the extension and print out or tell the pharmacy to print out the latest official Medi-Cal provider bulletin that will explain the details of the extension. A new provider bulletin is expected tonight or no later than tomorrow (Friday February 10). The Medi-Cal provider bulletin can be found at the official Medi-Cal website:
http://www.medi-cal.ca.gov OR visit the CDCAN website at www.cdcan.us for a copy of the latest Medi-Cal bulletins.

Hundreds of Thousands of People With Disabilities & Seniors Impacted
In mid-January, the California Department of Health Services, which oversees the state's Medicaid program (called Medi-Cal) estimated that over 200,000 of the State's 1 million persons with developmental or other disabilities and seniors who are dually eligible for both Medi-Cal and Medicare, were unable to obtain their needed medications.
The State says that most of these people have received their medications through the emergency drug coverage program.
Adding to that number, as of February 1, 2006, the number of Californians who could be impacted by the Medicare Part D Drug Program crisis increased by 10,000 persons with disabilities and seniors who were newly eligible for both Medicare and Medi-Cal, in addition to those persons who continue to experience difficulty in obtaining the medications they need.
* As of January 19, 2006, the State had filled 77,514 prescriptions under the emergency drug plan.
* As of January 25, 2006, the State had filled 141,211 prescriptions at a cost of $11.4 million
* As of February 8, 2006, California had filled 278,929 prescriptions at a cost of $20.3 million in state general fund dollars.

What SB 1233 Does
While the legislation cannot resolve problems caused by the original federal law passed by the US Congress in 2003, SB 1233 does provide temporary relief to tens of thousands of persons with disabilities and seniors by extending the emergency program originally established by an executive order by the Governor on January 12, and later extended in January by the passage of AB 132. That bill extended emergency drug coverage through February 11. SB 1233 does the following:
* Continues the emergency program the state originally established on January 12 through February 15. Provides the Governor with the authority to extend it further with additional 30 day extensions each, but not beyond May 16, 2006 (unless new legislation extends it beyond that date).
* Authorizes the Governor and the Department of Health Services to be the "payer of last resort" for persons who are dually eligible for Medicare and Medi-Cal and unable to get their medications through the Medicare program to ensure no dual eligibles leave the pharmacy without their needed prescription drugs. This means that pharmacies will be paid for medications - and people who need them can receive it, even if there names do not show up on the Medicare computer program, or their plan or the price of the medications is not correct.
* Continues authorization for the Department of Health Services to spend up to the $150 million cap in General Fund money, originally authorized in AB 132, for the purpose of the emergency drug coverage program.
* Provides the Department of Health Services the authority to seek reimbursement from the federal government and the Medicare Part D plans for the cost of this emergency action. The federal government has already given verbal assurances to the states in January that it would fully reimburse the states for the additional costs for drugs at least through February 15.

Gov. Urges Federal Government To Resolve Crisis - Praises Legislature For Action
Perata and Nunez Urge Repayment and Action from Federal Government
"This legislation will ensure California's low income seniors and persons with disabilities have access to the medications they desperately need while ongoing problems with the federal system are solved. I want to thank the Legislature for working together to take quick action on this legislation to ensure there will be no break in our citizens getting their necessary prescriptions filled," said the Governor, adding that "We will continue to work with the federal government to remedy the problems in transitioning this vulnerable population to Medicare prescription drug plans and to ensure California is fully reimbursed for the cost of this emergency action."

Meanwhile, Senate President Pro Tem Perata, who authored SB 1233, said that “While I'm pleased that the legislature and governor are once again able to come together to help vulnerable Californians, we can't keep using state tax dollars to patch up Washington's problem,” Perata said. “The Bush Administration needs to make the necessary changes to protect Medicare clients and they need to reimburse California for what we spend on this."
Perata noted the Bush administration has signaled a willingness to repay California for emergency funds spent, but only through February 15 and that if resolution is not forthcoming by the end of the month he will call on Governor Schwarzenegger to go back to Washington, D.C. saying that “When even the President’s brother is having trouble getting his prompt attention on this, we need Arnold Schwarzenegger– the one person in the country who can open enough Republican doors and spur enough media stories – to go back to Washington and get this solved.”

Assembly Speaker Nunez also urged the federal government to "clean up" its mess, saying that "While I also welcome the opportunity to work with the Governor and the Pro Tem on California’s pressing issues, the state should stop having to clean up the federal governments’ mess. There are more problems looming on the horizon since the federal government has only agreed to reimburse the state through February 15th, and recipients are changing their health plans and will be denied their drugs at pharmacies once again. The Administration and Congress should step up to the plate and solve this problem once and for all.”

The Assembly Speaker, who co-authored the legislation, added that "The Federal government needs to gets its act together. We are doing our part to make sure that the most vulnerable low income Californians – the elderly and the disabled – can get the medications they need. Now it’s time for the Republicans who control all branches of our Federal government to stop their foot dragging and do their part."

Background on Medicare Part D
* The new federal Medicare Part D Drug program, which applies also to persons with disabilities and seniors who are dually eligible for both Medi-Cal and Medicare in addition to those seniors who only are eligible for Medicare.
* The new federal drug plan does not impact persons who are only eligible for Medi-Cal.
* On January 1, 2006, under the Medicare Modernization Act passed by the US Congress in 2003, the federal government took responsibility for prescription drug coverage for those people who are dually eligible for both Medicaid (Medi-Cal) and Medicare.
* The transition of these individuals to Medicare plans, according to the California Department of Health Services, resulted in an error rate of 20% or impacting over 200,000 people with disabilities and seniors of 1 million Californians eligible for both Medicare and Medi-Cal. Advocates believe the number is much higher, especially among communities where English is a second language.
* As of February 1, 2006, the number of Californians impacted by the Medicare Part D Drug Program crisis increased by 10,000 persons with disabilities and seniors who were newly eligible for both Medicare and Medi-Cal, in addition to those persons who continue to experience difficulty in obtaining the medications they need.
* On January 12, 2006, Gov. Schwarzenegger, through an executive emergency order, implemented a 30 day emergency program to pay for prescription drugs for persons dual eligible for both Medi-Cal and Medicare and who have been unable to obtain them through their Medicare Part D Drug coverage and agreed with legislative leaders to pass legislation to fund this program. That legislation, AB 132, passed and extended the emergency program through February 11.
* Since that time, according to the California Department of Health Services, California has continued to fill more than 11,000 prescriptions each day.
* On February 1 a joint informational hearing held by the California State Legislative health, aging committees and budget subcommittees on health and human services heard from state and federal officials, advocates and others on the impact of the Medicare Part D Program on people with disabilities and seniors. No action was taken at that hearing.
* Also on February 1, the US Congress took final action on passing a key bill to implement the federal October 2005 September 2006 budget, called the "Deficit Reduction Act", which President Bush signed on February 8. That bill will have significant and widespread impact on many health and human service programs, but especially Medicaid - including establishing co-payments for services and drugs for certain Medicaid recipients, and changing federal laws relating to eligibility and transfer of assets.

OTHER MEDICARE PART D NEWS: FEDS RECALCULATE STATE COSTS
US Department of Health and Human Services Secretary Leavitt said today that the federal government would recalculate the costs to the states, including California, for the implementation of Medicare Part D Drug Program. The decision to recalculate means that California, referred to as "the clawback" - along with other states, would not spend more of its state money to implement the program for those who are dual eligible than it would have had to if Medi-Cal continued to provide the drugs.

The issue was the subject of a lawsuit filed by several states, including California, against the federal government. The federal government however did not mention whether it would reimburse states, including California, beyond February 15 for the additional costs of providing drugs to people with disabilities and seniors who are eligible for both Medi-Cal and Medicare and were not able to obtain those medications.

"This is a step in the right direction. I have worked in good faith for more than a year with Secretary Leavitt to address this issue to ensure California saves money on this program as Congress and the President intended when they passed and signed the Medicare Modernization Act." the Governor said in a press statement released today (February ) adding that "Instead of penalizing California at a cost of more than $77 million to implement the Medicare prescription drug program for our low income seniors and persons with disabilities, California will now save $43 million more than if Medi-Cal continued to provide medication for these vulnerable Californians. I want to thank Secretary Leavitt for his commitment to working together to ensure costs for a federal program are not borne by California taxpayers and make certain our low income seniors and persons with disabilities have access to the medications they need."

NEXT STEPS
* CDCAN Disability Rights Townhall Telemeeting - FEB 21, 1PM to 2:30 PM, on Medi-Cal issues, including update on Medicare Part D, and major focus on impact of passage of the federal "Deficit Reduction Act" and its impact on Medi-Cal, and people with developmental and other disabilities and seniors, their families, workers, organizations. Will feature officials from California Department of Health Services, including Stan Rosenstein, head of the state's Medi-Cal program. Townhall telemeetings are free - and a means for people with disabilities, seniors, their families, workers, organizations and other advocates to participate in policymaking no matter where they are. CDCAN says it is part of their "Advocacy without borders" program. To obtain toll-free number, see upcoming special CDCAN notice, or go to the CDCAN website next week at www.cdcan.us.

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 but not necessary). We're all in this together!