Maryland to Seek Reimbursement for Medicare Drug Expenses

Maryland is asking the federal government to reimburse its costs for trying to straighten out difficulties with the new senior citizen prescription medication plan called Medicare Part D.

The state's Department of Health and Mental Hygiene said it's still gathering information, awaiting final details of recoverable costs and calculating expenses, but an extremely rough estimate of its appeal would be around $1 million. The state assisted 1,600 confused callers and refilled more than 90 emergency prescriptions since the Jan. 1 start of the program.

"Administrative costs are the bulk of what the state of Maryland is going to be requesting," said Jeff Gruel, director of the Maryland Pharmacy Program.

Confusion reigned nationwide as senior citizens transitioned Jan. 1 into the new Medicare Part D program. Those particularly affected were "dual eligibles," senior citizens enrolled in both Medicare and Medicaid. System problems and plan complications have made it hard for these low-income senior citizens to get their prescription medicine at the correct reduced price.

"We are grateful for the additional federal funding because it will allow the state to continue assisting Medicaid beneficiaries in their transition to Part D," said S. Anthony McCann, DHMH secretary, in a written statement.

The federal Centers for Medicare and Medicaid Services announced the state reimbursement plan last week. Guidelines are still being set.

"We're still working out the details," said Peter Ashkenaz, spokesman for CMS.

Most states are expected to apply for reimbursement, he said.

In Maryland's case, the DHMH office fielded calls from confused patients and pharmacists.

"The problems are time consuming," Gruel said.

If the problem could not be solved, an emergency prescription was provided by the state in a "very limited" number of cases, he said.

The most difficult problem to rectify was when a senior citizen could not be found enrolled in any plan. Those people were charged large amounts of money at the pharmacy.

"They don't have that kind of money," Gruel said.

Calls to DHMH are down to about 30 a day from a high of more than 100.

More than two dozen other states have stepped in with more substantial financial assistance by paying for prescription assistance, including the District, where Mayor Anthony Williams pledged $3 million to help. The city is also working on applying for reimbursement "for very dime that we spent," according to Gregg Pane, director of the District Department of Health.

At the state legislative level, Maryland lawmakers are working to close a payment gap that could leave some seniors without funds they are used to getting from the Maryland Senior Prescription Drug Assistance Plan. The proposed fix will make aid available for all qualified participants.

Capital News Service contributed to this report.