Some states re-start Medicaid programs to fill drug coverage holes

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Several states have reinstated Medicaid or state pharmacy assistance program drug coverage since the launch of the Medicare Part D drug program to bridge the coverage gap for dual eligibles.

Many dual eligibles – or those who are eligible for Medicaid and Medicare – have not been able to access drugs under the new program, which started Jan. 1. Advocates for the elderly have expressed concern for several months about the dual eligible population's ability to receive drugs under the program. About 70% of nursing home residents are considered dual eligibles.

States reinstituting Medicaid or state pharmacy program coverage include Arkansas, Connecticut, Hawaii, Maine, New Jersey, North Dakota, Rhode Island, and South Dakota. Under the drug program, state Medicaid programs do not have to provide coverage to dual eligibles. But state programs are expected to reimburse the federal government.

Just days after the program began, Maine opted to reinstate state-funded drug coverage for 45,000 dual eligibles. It took this in action, in part, because dual eligibles were charged higher than expected copayments under the new Medicare drug program. The state wants compensation from the federal government for providing coverage during the transitional period to Medicare Part D.