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ASSEMBLY & SENATE OVERRIDE
GOVERNOR’S VETO ON MEDICARE PART D!
The
Senate passed a stunning overrode of Governor Pataki's veto by a
58-0 vote without any debate, following the Assembly vote of
141-0. The override means the Legislature's law (A.
9462) takes effect immediately and is retroactive to
January 1, 2006. It calls for the state to pick up costs for
medications not covered under Medicare D, the federal prescription
drug program that started Jan. 1st.
DOH Commissioner Novello tried to
claim the bill had several "glitches," and defended Pataki's veto,
pointing out technical problems, but a thorough read of both the
bill and the Veto produce no apparent glitches or problems. (See
www.nysacra.org or these links for
Bill A. 9462
&
Veto Message #1.)
Novello said the Governor already
approved picking up the tab through March 8th for an estimated
600,000 people who, for various reasons, aren't showing up on
Medicare rolls. They include people who were on Medicaid, but
were supposed to be automatically transferred to Medicare D.
Pataki also called for picking up costs through July 1, 2006 for
people in the system whose health plans aren't recognizing certain
prescriptions. However, it was NYSACRA’s contention and that of
many others, that the Governor’s week-to-week, “are we covered or
are we not”, emergency actions issued late on Fridays, was not the
right method of addressing the problem.
The new law,
A. 9462,
simply requires emergency coverage of prescription drugs for those
dually eligible until the DOH Commissioner declares “that
operational problems associated with the implementation of
Medicare Part D have been resolved and that emergency coverage
under this section is no longer necessary”
The Bill further states that “The
commissioner shall provide that individuals receive medical
assistance under this section through an easy and simple process
which shall not include a requirement that individuals or their
providers receive a formal denial or a coverage determination from
a Medicare Part D plan, or any other appeal within Medicare Part
D, as a condition of eligibility. The commissioner shall provide
pharmacists, beneficiaries, and advocacy organizations with
information about accessing medical assistance under this section.
The State would continue to pursue
reimbursement from the Federal Government for covering these
costs, as they have for the last few weeks. NYSACRA thanks its
members for your continued efforts on this matter, from day 1,
through the NYSACRA Legislative Day, and ongoing today, our
advocacy does have an impact, and you deserve the credit.
In a related matter the HHS
Secretary Levitt published a “One
Month Progress Report” this week, copies are available at
www.nysacra.org or by
Clicking Here. The report acknowledges the pitfalls but
strikes a positive future tone with the expectation that it will
indeed become the grand plan they envisioned. HHS says that it is
committed to fixing the problems and working with the States.
Furthermore, as reported last week,
HHS Secretary Mike Leavitt announced that the transitional
coverage period for Medicare Part D has been extended from 30 to
90 days, giving an additional 60 days of transition coverage.
During the transition period, beneficiaries should be able to
continue to get medications they are taking which are not covered
by their Part D plan's formulary. The transition period is
intended to give service providers the opportunity to review and
switch plans, request formulary exceptions or find alternative
medications. |
