CMS Urging States To Provide Extended-Supply Scripts To "Dual-Eligibles"
This article was originally published in The Pink Sheet Daily
Executive Summary
Prescriptions for 60- or 90-day supplies given to dual-eligibles at the end of 2005 would still receive federal matching coverage for state Medicaid programs and could decrease the likelihood of beneficiary coverage gaps, CMS Deputy Administrator Norwalk says.
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The Centers for Medicare & Medicaid Services is urging state Medicaid programs to give "dual-eligible" beneficiaries extended-supply prescriptions at the end of the year, CMS Deputy Administrator Leslie Norwalk said. The prescriptions could soften the financial impact on the states of transferring coverage of dual-eligibles' prescription drug costs from Medicaid to Medicare and help decrease the likelihood of beneficiary coverage gaps, she said. "We're going to draft a letter to state Medicaid directors that lets them know that while the...federal match to the Medicaid program will not be available for drugs after Jan. 1, one thing that a state might do is to give Medicaid beneficiaries who are dual-eligible an extended supply of prescriptions near the end of the year," Norwalk said at the National Managed Health Care Conference in Washington, D.C. March 7. The Medicare Modernization Act dictates that state Medicaid programs will be unable to obtain federal matching funds for dual-eligibles' drug costs after Jan. 1, 2006. However, CMS is not required to auto-enroll dual-eligibles who have not signed themselves up for a Medicare Part D prescription drug plan until May 15, 2006. CMS Administrator Mark McClellan has said that all dual-eligibles will be automatically enrolled in a Medicare Part D plan by Jan. 1 so as to avoid any gaps in coverage (1 (Also see "All Dual-Eligibles Will Be Enrolled In Medicare Part D By Start Date, McClellan Says" - Pink Sheet, 19 Nov, 2004.)) Nevertheless, Norwalk suggested that states could provide dual-eligible Medicaid beneficiaries with a prescription "supply that would go into January or February, 60 or 90 days." "You would continue to get the federal match for that and beneficiaries would have the access to drugs they need in the short term," she said. - Andrew Shelton |