At least six states are taking emergency steps to help low-income senior citizens and the disabled get their medicine because of problems with the new Medicare prescription drug benefit.
Several more states say they are reviewing whether they need to take such action as complaints come in from patients and pharmacists. Under a program that began Jan. 1, Medicare beneficiaries enrolled in private plans are supposed to have prescription drug coverage subsidized by the government.
On Tuesday, lawmakers in New Hampshire authorized up to $500,000 for payments to pharmacists who give a 10-day supply of drugs to elderly people having trouble getting their medicines.
The day before, South Dakota began a program that allows people who qualify for both Medicare and Medicaid to get a 30-day supply of medicine.
"By then, we hope that problems with the new (Medicare benefit) will be resolved," said the state's Republican governor, Mike Rounds.
Previously, Vermont, Connecticut, Massachusetts and North Dakota had announced plans that would enable low-income people to get their medicine if pharmacists were having trouble confirming coverage through the new Medicare benefit.
In many instances, people who enrolled in plans are not listed as participating when the pharmacies check their computers.
In Arizona, nearly 20,000 people who should have been automatically enrolled in a plan because of their income levels were not. "When they couldn't get their meds, they were calling us," said Alan Schafer, who runs the state's long-term care program.
He said state officials were meeting this week with Medicare and health insurance officials to sort out the problems.
Sen. Frank Lautenberg, D-N.J., said Tuesday that his state has spent $4.4 million of its own money since 4 p.m. Friday on residents who should have been covered under the new federal program. He said he would introduce legislation requiring reimbursement for such states.
"While states are bailing out the Bush administration for these failures, they shouldn't have to wonder whether they will get repaid. The states must be repaid, with appropriate interest," said Lautenberg.
However, some states are reporting fewer problems.
"From our perspective, the transition is going quite smoothly overall," said Jonathan Burns, a spokesman for the Florida Agency for Health Care Administration.
"We're keeping a very close eye on it, but at this point, nothing seems to point to the need for a state response," said Lara Azar, spokeswoman for Wyoming Gov. Dave Freudenthal, a Democrat.
Georgia is not spending state money to cover drug costs stemming from problems or confusion with the Medicare prescription drug effort, said Dan McLagan, spokesman for Republican Gov. Sonny Perdue. The state has not seen any notable problems and no action is anticipated, McLagan said.
Gary Karr, a spokesman for the Centers for Medicare and Medicaid Services, said the agency believes problems with the new program are getting worked out every day.
"From the reports we're hearing, things are going much smoother," Karr said. "While there are reports of problems in some states, in many states there appear to be no problems."
Karr said there is no mechanism in place that would allow the federal government to repay states spending their own money on prescription drugs for Medicare beneficiaries.
"We expected some imperfections as you move 21 million people into a new benefit in less than a month, but overwhelmingly, people are getting their prescriptions filled every day," he said.
However, some advocacy groups report being flooded with complaints.
"The opening week of the Medicare prescription drug benefit was a disaster," said Judith Stein, executive director of the Center for Medicare Advocacy Inc. "If this was a Broadway show, the curtain would already be coming down."