Report: California faces big task with "dual eligibles"

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California faces a major challenge in transferring drug coverage for 1 million dual-eligible Medicare recipients under the pending Medicare Part D drug plan, a report issued last week warned.

The new federal regulations will present challenges for providers and local officials across the country, but California has a higher number of dual eligible beneficiaries than any other state. Decisions that legislators and health officials make will affect not only seniors and disabled persons, but also the state budget, the paper notes.

The law requires that that dual eligibles – those eligible for both Medicare and Medicaid assistance – switch to Part D drug coverage in less than a year. This requirement "will create significant operational and financial challenges for the state and county government agencies responsible for implementing key elements of the new drug benefit for low-income residents," the paper said.

Health Strategies Consultancy of Washington created the report. It is the first in a series of issue briefs it is preparing for the Oakland, CA-based California Healthcare Foundation, regarding the impact of the Medicare Modernization Act on the state.

One of the major challenges for state officials will simply be identifying all the dual eligibles, given the diverse nature of the population. Also, because dual eligibles who are residents of the same nursing home might be enrolled in different Medicare drug plans, those long-term care providers will now have to grapple with multiple formularies, the report added.