State seeks new Medicare Rx extension

AUGUSTA – Gov. John E. Baldacci is asking federal officials for another three-week extension of the deadline to be repaid for the costs of providing prescription drugs to Mainers not yet properly enrolled in the new federal Medicare Part D program.

The state has been covering the costs of prescriptions for thousands of Mainers whose benefits have been held up because of computer errors and other startup problems with the new program since it went into effect Jan. 1.

Federal safety net payments initially had been promised through mid-February and then extended through March 8 to compensate the state for its costs while the problems were being worked out.

But Baldacci said Tuesday that more than 10,000 low-income Mainers who are eligible for the program still aren’t properly registered.

“While much progress has been made in successfully moving people into Medicare Prescription Drug Plans, there still remain many outstanding issues with identifying Low Income Subsidy (LIS) eligible members,” Baldacci wrote to federal Health and Human Services Secretary Michael Leavitt. “We are requesting an extension in the repayment deadline until 3/31/06 since so many of our enrollees continue to have high co-pays and are being charged deductibles inappropriately.”

The governor said he believes this extension also will be granted as state and federal officials continue their efforts to make the Medicare program work properly.

Jude Walsh, a special assistant to Baldacci who works in his health policy office, said a computer run Tuesday morning indicated 10,683 Mainers who are eligible for the highest federal subsidy plan had not been identified as eligible for those subsidies by federal officials.

“These are the people that need the help the most, and right now they are being charged co-pays that are too high,” she said.

Maine was spending up to $100,000 a day at one point to make sure Mainers received the drugs they needed at the prices they should be paying, Walsh said. That amount has since gone down to about $10,000 a day, she said, adding that the federal government has been reimbursing the state for those payments.

Walsh, who is scheduled to testify before Congress today on the problems facing the implementation of the Medicare Part D program, said the program is “incredibly” complex. She said Maine and the other states get several different computer files from different federal agencies every month and that they all have to be reconciled with the state’s data.

“This is just so complicated,” Walsh said. “I have this flow chart made to keep track of the various computer files and when they come in and how they match with ours.”

Adding to the difficulties is how hard it has been getting all those Mainers eligible for some level of coverage to apply for the program. Advocates for the poor, such as Mary McPherson with the Maine Equal Justice Project, say getting many of those eligible to sign up has proved far more difficult than expected.

“For example, there have been efforts for years to warn seniors not to give out their Social Security number over the phone,” she said. So when state employees or volunteers call these seniors on the phone and ask them for personal information in order to enroll them in a drug benefit plan, the elderly Mainers sometimes suspect a scam and hang up.

McPherson said some staffers from the local Area Agencies on Aging have had to go in person to some seniors to get them to give them the information needed to fill out the forms. She said the federal government assumed a level of computer literacy and accessibility among seniors that does not exist.

“It’s going to take time to get all these people enrolled in the right program for them,” she said.

Kitty Purrington with the Maine Association of Mental Health Services is a member of the state Medicare “stakeholder” advisory group. She said in many cases the application forms are very confusing for many of those Mainers who are eligible for the subsidy program.

“These folks also often have very complex medication regimens that make them very resistant to any change,” she said. “There is a lot of fear out there. This is a very vulnerable group.”

Walsh agreed and said extensive outreach efforts have been made by the state and by federal agencies. She said the state made more than 25,000 telephone calls, and the Social Security Administration has sent two mailings to its recipients explaining the Medicare Part D program.

Rob Clark, a Maine spokesman for Social Security, said the agency is working with the state to develop an additional outreach effort this spring. He said the agency will use the state computer file of those who have not enrolled and match that with the Social Security file of Maine recipients.

“We will then be calling those individuals and urge them to enroll and provide them help with enrolling,” he said.

Clark said individuals will be given a number at the agency to call back to complete the enrollment process so they will have confidence they are dealing with the agency and not a phone scam artist.

McPherson said it will take a long time to get everyone signed up but that the local Area Agencies on Aging are available to help and have been “on the front lines” of signing up Mainers for the right benefit package.

To reach your local Area Agency on Aging, call (877) 353-3771.