Drug plans to reimburse states, LTC pharmacists appeal for help

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As the government grapples with new complaints from pharmacists about the Medicare Part D drug program, an insurance industry representative has assured states that Medicare drug plans will reimburse them for the cost of providing emergency prescription drug coverage.

Karen Ignagni, president of Washington-based America's Health Insurance Plans (AHIP) said drug plans will refund money to states and quickly transition dual eligible enrollees to Medicare once the Centers for Medicare & Medicaid Services provides accurate information on all beneficiaries.

Speaking Jan. 19 during a conference sponsored by the Stanford Washington Research Group, Ignagni said the glitches in the system stem from inaccurate information about health plan enrollees. She further noted the information did not come from health plans but from a CMS contractor. AHIP is a national association representing nearly 1, 300 health plans.

CMS officials have said the agency is reviewing its computer system and data files to identify and resolve problems, and it will be sending a new data file to drug plans that identifies all dual eligibles covered within each plan.

Nearly two dozen states have stepped in to pay for prescription drugs for dual eligible beneficiaries who have not been able to receive drugs under the new benefit.

Meanwhile, the American Society of Consultant Pharmacists submitted a letter to CMS asking for urgent intervention to solve the crisis in the program. Millions of dollars in unpaid or underpaid claims are exerting financial pressure on long-term care pharmacies, the association says.