Jan. 4, 2006 – Four days into the implementation of the new Medicare prescription-drug plan, reports from across the nation show a program in disarray as patients, pharmacists and doctors attempt to understand and make use of the benefits offered under the 2003 legislation.
Many of those who previously enrolled in the program, which went into effect on January 1, have yet to receive the cards or verification letters that would allow them to fill their prescriptions under the new pricing system. Those without cards or letters had to wait while pharmacists attempted to verify their enrollment through a privately run database system that was reportedly jammed by heavy traffic.
"We have had difficulty processing claims for Medicare drug benefits," Tony P. Welder, who owns the Dakota Pharmacy in Bismarck, North Dakota, told the New York Times. "We will get through it, but at the moment, it's an awful mess and very frustrating for our patients."
"Perhaps," Welder quipped, "we should give out cell-phone numbers for members of Congress so that our patients can call them for help."
Pharmacists across the country recounted to the media that the database, run by Medicare contractor NDCHealth, was often inaccessible or uselessly slow throughout Monday and into Tuesday, the busiest days since the program went into affect.
"It's awful. It's an absolute nightmare," Rich Harvie, a Montpelier Vermont pharmacist told the Associated Press. Havie, who works at Brooks Drug reported that the database was frequently unavailable or offered the wrong information and that the companies administering the various drug plans were often impossible to reach by phone.
In enrolling, Medicare recipients were given a variety of options for drug coverage from private companies. For months, beneficiaries have struggled to navigate the enrollment process, which by most accounts was nightmarishly confusing. Many people reported receiving little help from government agencies and websites as they attempted to navigate the complicated process of figuring out which plans to sign up for.
According to Medicare officials, pharmacies were instructed to provide patients a monthâ€™s supply of their drugs if they could not figure out their enrollment status. But some pharmacies apparently did not know about that policy or were not complying with it.
Many people told the press that they were turned away from pharmacies without their medicines.
The Medicare drug program, known as Medicare Part D for the portion of the 2003 Medicare Modernization Act covering prescriptions, has been under heavy criticism from consumer and medical groups for months.
The American Association of Retired Persons (AARP) â€“ one of the nationâ€™s largest lobbying groups â€“ reported in its latest publication that many may find drug costs under the program cheaper than ordering the same medications from Canada. The report also noted, however, that many seniors would not take advantage of the program because of the difficulty of signing up for it.
Calling January 1 "a watershed day for many Americans," AARP Chief Executive Officer Bill Novelli applauded the new program in a statement announcing the organizationâ€™s report. "Millions of Americans who have never had drug coverage can now save more money through Medicare Part D rather than turning to Canada to get their prescriptions," Novelli said.
Indeed, some enrollees in the program received their drugs without a hitch and often with deep discounts.
Margaret A. Riney told the New York Times that she was able to fill her prescriptions at her Cincinnati Walgreens easily when she presented her enrollment card. She said she saved about $104 on two medications.
"I feel pretty good about things today," Riney told the Times. "I just hope, as I need more medications, that it's this easy. I thought about not signing up for the plan because it was so confusing, but I was paying way too much for my pills. I think I did the right thing."
But Consumers Union and other groups have warned that premiums and co-payments may be too high for many of the 42 million potential discount recipients. The group was especially critical of Congressâ€™ decision to prohibit price negotiations with drug companies and projected that little more than a fifth of prescription costs would be covered by the bill.
While groups and individual experts spar over the ultimate costs and benefits of the program, thousands of recipients and the medical network set up to serve them are experiencing long lines, unanswered questions and other frustrations as they navigate the new system.