ASSEMBLY PANEL CLEARS MEASURE
TO HELP RESIDENTS NAVIGATE NEW MEDICARE SYSTEM
Conaway/Conners/Cohen Bill Would Create Assistance and Information Center
For Senior Citizens and Disabled Residents(TRENTON) --The Assembly Health and Senior Services Committee today released legislation that would establish a toll-free state hotline to assist residents in registering for the new, problem-plagued federal Medicare prescription-drug benefit.

The bill (A-2237) is sponsored by Assemblymen Herb Conaway, MD (D-Burlington), Jack Conners (D-Camden), and Neil Cohen (D-Union).

The bill would authorize the state Department of Health and Senior Services to operate the hotline. The service would enable the state to document consumer complaints and provide assistance to callers through information and referrals.

The bill also would establish a Medicare Part D ombudsman who would oversee the hotline and coordinate state efforts to petition the federal government for reimbursement of coverage of so-called "dual-eligibles," primarily infirm elderly residents who are eligible for both Medicaid and Medicare benefits.

"As a physician, I have seen the confusion that has encumbered the process of bringing Medicare prescription coverage to the public," said Conaway, Chairman of the health and senior services panel. "New Jerseyans need help during this transition and communicate to the federal government how to best serve our seniors and provide them with the coverage they deserve."

"There needs to be a better way to deal with the federal government's prescription drug debacle," said Conners. "New Jersey seniors are faced with 54 different options. The state has a responsibility to fill the federal void for failing to provide a seamless, understandable prescription drug delivery system."

"This hotline is sorely needed," said Cohen. "We must make sure at-risk elderly residents acquire their life-saving medications. A failure to do this could result in a wave of new emergency room admissions, which would pose other cost implications for the state."

In 2003, the federal government enacted the Medicare Modernization Act (MMA) which established Medicare Part D. Through Part D, Medicare would provide a prescription drug benefit for Medicare eligible citizens. The program, which started enrollment January 1, 2006, requires Medicare recipients to enroll with a health insurer who provides prescription drug coverage. Medicare then reimburses the insurer.

Since enrollment began there have been numerous complaints from Medicare recipients. The largest problem is selecting an insurer that provides the coverage needed for the particular individual. The press has documented incidents where Medicare enrollees are being informed by pharmacists their prescription is not covered by their insurance. Additionally, there have been bureaucratic problems and clerical errors in the system.

Another problem that has arisen is with those who are both Medicare and Medicaid eligible. Under the state's Pharmaceutical Assistance to the Aged and Disabled (PAAD), these enrollees did not have a copayment. However, the MMA requires a $5 copayment for all enrollees.

Since dual eligibles are by definition financially strained, and many require an assortment of medication, the accumulative copayments have proven burdensome. Consequently, the State has been covering the copayments for the dual eligibles at a cost of $1.3 million per day.

The committee released the measure after a 9 to 0 vote. The bill now goes to the Assembly Speaker who decides if and when to post it for a floor vote.

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