Officials request waiver for Medicare plan

02/15/2006

Computer glitches kept drugs from enrollees

BY RACHEL E. STASSEN-BERGER
Pioneer Press

Minnesota officials Tuesday asked for quick federal intervention to allow the state to continue helping low-income seniors and disabled people ensnarled in problems with the new Medicare drug program.

Gov. Tim Pawlenty said he has talked to U.S. Health and Human Services Secretary Mike Leavitt and feels assured the needed waiver will be granted this week. The waiver will work like a grant to allow Minnesota to spend money with the expectation of reimbursement from federal coffers.

Last month, Pawlenty ordered the state to fund prescriptions for Medicare enrollees whose drugs costs are supposed to be largely provided by the new federal drug program. When the program was implemented at the beginning of the year, it quickly became clear the enrollees who are eligible for both Medicare and Medicaid had extreme difficulties getting their heavily discounted drugs because of glitches and computer problems.

The governor’s order is set to expire at midnight Friday, and state law does not allow him to extend it without legislative approval.

Over the weekend, Pawlenty seriously considered calling lawmakers back to the state Capitol this Friday to grant that approval. Without his call, lawmakers are due back on March 1.

Once the Legislature is back in session, lawmakers might need to pass a measure to allow the state to continue filling in the drug gaps.

“We continue to have concerns,” said Pawlenty, who said the implementation of the new drug program was bungled.
Since mid-January the state has paid for the drug costs in more than 52,000 claims. When Pawlenty first signed the order, the state was fulfilling about 9,000 prescription claims every day. Now the state is paying for 3,000 to 4,000 claims a day.

Christine Bronson, Medicaid director at the Minnesota Human Services Department, said fewer people need help, largely because the state, insurance companies and others have found ways to work around the problems. But the problems at the federal level, which have affected millions of people nationally, still haven’t been solved.

“They say they are making progress and they are working on it really hard and things are getting better,” said Pawlenty. “So, I guess I’ll just adopt the Reagan line of ‘trust but verify.’ “

In January, the Republican governor voiced serious frustration with the “horribly complicated” drug program, which he said was implemented in an “awful fashion.” On Tuesday, the governor sounded more conciliatory.

“People make mistakes. Computers go goofy and it is part of the stuff of life that sometimes things don’t go perfectly and you got to go back and fix them. It is just unfortunate that it happened with such a high-profile and important program,” Pawlenty said.

So far, Minnesota has spent about $3.5 million to buy drugs for those who were supposed to have almost all their costs taken care of by Medicare. Other states have spent far more — New Jersey, for instance, has been paying about $1 million a day since January to fill in the drug gap. Federal officials have said they will reimburse the states.