Survey: Majority of states report Part D problems among dual eligibles

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A total of 31 states have experienced widespread problems among their dual eligible residents transitioning to Medicare part D prescription drug coverage, according to a 50-state survey of Medicaid officials. The problems occurred during the implementation of the benefit in January.

The most common problems reported by state officials included: incorrect cost-sharing charged to beneficiaries (49 states), pharmacies not being able to obtain details to bill plans (44 states) and beneficiaries being unable to obtain non-formulary drugs (43 states). The Kaiser Foundation commissioned the survey and Health Management Associates conducted it. A majority of nursing home residents are dual eligibles (those who receive Medicaid and Medicare).

Fifty Medicaid officials responded to the survey; 37 of those reported that their states had implemented temporary coverage programs for dual eligibles and many have incurred hefty costs. Illinois, for example, estimated that administrative costs of providing temporary assistance to dual eligible totaled $1 to $2 million. Meanwhile, New York has spent $4 million and Pennsylvania has spent $2 million, according to the survey.