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State to save cash via Medicare cuts
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by Jacob Croal
Thursday, March 2, 2006
Wisconsin will save $22 million in Medicare costs because of an announcement of a cut in the predicted budget from last July by the federal government.
President Bush announced the $58 billion cut in a radio address Saturday. The cut means Wisconsin will now have to pay the government $204.5 million instead of $226.5 million as was originally projected for the state's Medicare costs.
"The federal government originally paid 60 percent of Medicare costs while the states would pay 40 percent," Wisconsin Department of Health and Family Services spokesperson Stephanie Marquis said. "Under this plan the states will only have to pay 10 percent while the feds pays 90."
Marquis added the states will have to use some of the money they save to pay the federal government to support the new Medicare program in what is called a "clawback."
The budget cut comes in the wake of the transition to the new Medicare Part D program.
On Jan. 1, 2006, the new program went into place, combining recipients covered under both Medicare and Medicaid, known as dual-eligibles, under one program.
Problems arose at pharmacies within a week of the switch, however, when people were not showing up in the computer system as being covered by the new program.
"It was a lot of work [with the transition] at the beginning, but it's getting better as we go," said a Walgreens pharmacist technician who chose to remain anonymous.
Hotlines for the federal and state Medicare programs — along with the 47 Medicare prescription drug providers in Wisconsin — initially received thousands of complaints.
Marquis said calls of complaints have been less frequent as of late, and are now in the hundreds area.
Along recipients' information not showing up in the computer database, others were enrolled in the wrong plan or were in a higher payment bracket than necessary. These problems led to people having to pay more than expected for medication.
In response to the problems, Gov. Jim Doyle extended emergency coverage Jan. 13 to anyone who was affected.
"We don't know how many have been affected yet and we may never know," she added. The coverage will allow pharmacists to give subsides that Medicare participants would normally get and the pharmacies will then be reimbursed directly by the state instead appealing to the prescription drug providers who are funded by the federal government, which they are normally required to do.
The federal government will then reimburse the state, which officials expect to occur by May, Marquis said.
Wisconsin has 110,000 people out of the 6.5 million nationwide enrolled in Medicare programs.
Kelley Flury, spokeswoman for state Sen. Judy Robson, D-Beloit, said Wisconsin's own version of Medicare — known as SeniorCare — is better for most individuals, rather than Medicare Part D.
"SeniorCare actually provides better [medicinal] coverage," Flury said.
SeniorCare, also for those aged 65 and older, offers co-payments of $5 for generic medicines and $15 for brand-name drugs. In addition, there are no income tests for SeniorCare, while Part D has very tight income restrictions.
