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The Medicare prescription drug law is likely to make it more difficult for the estimated 3 million beneficiaries in long-term care facilities to receive necessary medications, according to a Kaiser Family Foundation study.

The pharmacies providing drugs to facilities may not all be included in the new Medicare prescription drug plan, limiting nursing home residents’ access to medications. About 80% of nursing home beds currently are served by such pharmacies specializing in providing to long-term care facilities.

However, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 does not authorize the creation of prescription drug plans to service nursing homes, according to the report conducted by Center for Medicare Advocacy attorney Vicki Gottlich.

An exception requirement could help residents get the medications they need, but many could be deterred by cognitive impairment and the lack of intermediaries to act on their behalf, said study authors. Other solutions given in the study also involve difficulty. Congress could authorize stand-alone drug plans in addition to Medicare Advantage plans to serve long-term care residents, but sponsors might be wary. Also, Congress could authorize ombudsmen to assist patients in getting needed medications.