Glitchy Systems Worsen Drug-Benefit Snafus

 
 
By Deborah Gage  |  Posted 2006-01-11
 
 
 
As the year ended, Bonnie Burns—a training and policy specialist with California Health Advocates, a nonprofit that counsels people on Medicare—was stretched to the limit.

She was swamped with requests for help from senior citizens afraid of losing coverage for their prescription drugs under the new Medicare drug benefit, which took effect on Jan. 1, 2006.

Her own stepfather was having problems, too. In November, she couldnt figure out if the nine drugs he takes for a lung condition would be covered under his new plan.

Under the program, her stepfather and all other recipients of Medicaid—a joint federal-state program—who had been receiving their drug coverage from the states were automatically assigned to insurance companies that are supposed to be covering their drugs on behalf of the federal government.

But the Medicare Web site and her parents insurance plan, SecureHorizons from PacifiCare, were giving Burns conflicting information.

Burns is not alone. Across the country, seniors and those caring for them remain uncertain as to what, if any, prescription drug coverage theyll have under the new program.

Click here to read more about Medicares difficulties with health care-related IT.

On Dec. 22, 2005, the Department of Health and Human Services said 21 million people were enrolled in the plan. The program—under which, for the first time, the federal government will offer to subsidize prescription drug costs for everyone enrolled in Medicare, currently 43.1 million people—is complicated.

California, for example, offers 47 different statewide plans that cover drugs, plus 85 local plans that cover medications and other health care.

Seniors and their advocates must sort through an array of choices from private insurers, whose plans differ in how much they charge, which drugs they cover and which pharmacies they allow seniors to use.

And the computers powering the program havent helped the situation.

The system has run into a number of problems, which have ranged from Web site crashes that prevented people from signing up online, to the failure to match state and federal files of beneficiaries, to the inability to display online information for beneficiaries to review.

Read the full story on Baselinemag.com: Glitchy Systems Worsen Drug-Benefit Snafus

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