Monday, December 19, 2005

This really is incredible -- not only are some nursing-home patients going to be switched to more porous drug coverage than they currently have under Medicaid, but the people who run their nursing homes can't even found out what plans the government has assigned them to:

Two weeks before the start of the Medicare prescription drug benefit, pharmacists and nursing homes are desperately trying to find out who will pay for the medicines taken by hundreds of thousands of their residents.

... About two-thirds of the 1.5 million residents of nursing homes are participants in both Medicare and Medicaid. The government has randomly assigned them to private drug plans, regardless of their needs.

In many cases, nursing home officials said, they do not know to which plans their patients have been assigned....

...Dr. Robert A. Zorowitz, chief medical officer at the Hebrew Home for the Aged in the Bronx, said he had tried to obtain information on residents from the Medicare Web site.

"It worked at some times for some patients, but not for others," Dr. Zorowitz said. "It's inconsistent."

A federal contractor, NDCHealth, is loading information onto the Web site of the Centers for Medicare and Medicaid Services, known as C.M.S.

A spokesman for the company, Robert P. Borchert, said: "We are waiting for data from C.M.S. We don't have a full set of data. The information is there for some beneficiaries and not yet for others. It's still in a test mode." ...

It's still in a test mode?? IT'S DECEMBER 19, YOU IDIOT.

The nursing homes need to know what plans these people are on in order to determine what drugs the plans will cover. Each plan has a formulary -- a list of drugs it will and won't cover. A patient who's now on a drug that won't be covered will probably need to be switched to whatever substitute drug is covered -- if the nursing home knows what drug that is (impossible to determine if the nursing home can't identify the patient's plan):

"In the next two weeks," Ms. Tarnove said, "doctors have to review the drug regimens of almost all nursing home residents and rewrite the prescriptions to comply with Medicare drug plan formularies. There could be a dozen plans with a dozen formularies in one nursing home."

Thanks, GOP!

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