8039 AMS BENS SEIB 02

SJM 8039 - S AMD 38

   By    Senator Benson

NOT ADOPTED 2/8/2006

   On page 1, beginning with "WHEREAS" on line 8, strike all material through "medications." on page 3, line 14, and insert the following:

   "WHEREAS, Beginning January 1, 2006, 831,000 Medicare enrollees in Washington state were among the 43 million Americans provided prescription drug coverage through the Medicare Part D program, giving many, for the first time, access to prescription drugs that they had previously struggled to afford; and

   WHEREAS, Medicare beneficiaries now have numerous choices for prescription drug coverage, allowing them to pick the plan which best suits their personal circumstances, but for which they need sufficient time and information to understand and select; and

   WHEREAS, Problems and administrative delays when initiating a nationwide assistance program of this magnitude are extremely unfortunate, but inevitable; and

   WHEREAS, It is essential to be particularly attentive to the impact of this program on "dual eligibles," the approximately 96,000 low-income residents of Washington who will now receive prescription drug coverage under Medicare rather than Medicaid; and

   WHEREAS, In the transition to this new program, where dual eligibles are particularly vulnerable in the face of technological glitches and poor communication that could delay their access to needed medications, we should insist that as much as possible be done to avoid these problems and that they be addressed immediately when they occur; and

   WHEREAS, Even for someone correctly transitioned, there is concern that the particular drugs the person needs will not be covered by Part D, or that newly required co-pays will prove unaffordable; and

   WHEREAS, The federal government has been working diligently to address these transition issues, including a $14 million credit which will allow this state to cover any unaffordable co-pays, and the development of a waiver program to assist states with other unanticipated costs, but will benefit from continued input and information from the states regarding particular steps which might be taken to reach the full promise of the Medicare Part D program;

   NOW, THEREFORE, Your Memorialists respectfully pray that the Congress and the Administration address concerns with the Medicare Part D program through rule making and, as necessary, through changes to the Medicare Modernization Act, by specifically doing the following:

   (1) Upgrading the Centers for Medicare and Medicaid's customer service system to assist clients seeking information;

   (2) Extending the enrollment period beyond the May 15, 2006, deadline;

   (3) Requiring all health plans that contract with the Centers for Medicare and Medicaid Services to provide uniform transition policies that provide a 30-day supply of needed drugs;

   (4) Reimbursing states and pharmacists who have assumed the costs for covering individuals who have had transition problems; and

   (5) Repealing the prohibition on the use of Medicaid funds to provide: Wraparound Medicare prescription drug benefits for the transition of dual eligibles; copayments for dual eligibles and low-income beneficiaries; and needed coverage if a particular plan's restricted formulary or network denies access to the most medically appropriate medications."

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