Senior Spotlight By John Toscano
Senior Advocate Warns About More Part D Foul-Ups

More than 1 million low-income Medicare members who are enrolled in the Part D federal prescription drug subsidy plan are facing the same problems this coming year that plagued the program when it opened for the first time last January, according to the Medicare Rights Center (MRC).

Last year, said Robert Hayes, president of MRC, the Center for Medicare & Medicaid Services, which operates Part D, failed to heed repeated warnings about the problems expected when poor people's drug coverage is interrupted.

"Thousands of Americans were denied their medicine and 37 state governments were forced to launch emergency rescue programs," Hayes said.

Now, as millions of Medicare members are looking into their 2007 coverage, Hayes and the MRC are calling on the Center for Medicare & Medicaid Services to avert a crisis for the more than 1 million low-income individuals enrolled in Part D who will face steep increases in prescription drug costs and abrupt changes in drug coverage when the New Year begins.

Hayes said that some of the changes are:

•Reassigning about 288,000 lowincome

older and disabled Americans to new Medicare private drug plans beginning Jan. 1, 2007 because their current drug plan premiums are too high to qualify for "Extra Help", the federal subsidy that helps low-income people pay for their Part D coverage.

•Reassigning hundreds of thousands of low-income people with Medicare to new plans offered by the same private drug plan insurance company, with no guarantees that their medicines will be covered.

•Dropping an additional 630,000 people eligible for Extra Help this year from the federally subsidized program in 2007. Most of these poor, older and disabled Americans still qualify for the subsidy, but are no longer listed on the Medicaid enrollment files, triggering automatic enrollment in Extra Help.

Regarding the 288,000 low-income and disabled persons who will be reassigned to new plans, Hayes said this will impact people with Medicare in 40 states and will be done without regard to whether new plans cover the drugs on an individual's medication regimen, according to a new Medicare Rights Center report, "Part D 2007: Addressing Access Problems for Low-Income People with Medicare".

Hayes said his center has a plan to deal with those who will be reassigned with no guarantees that their medicines will still be covered. Hayes would lift any restrictions on any drug regimens covered under an individual's 2006 plan and mandate that 2007 Part D plans include any exceptions and prior authorization requests granted in 2006.

Also, Hayes calls for creating a Special Enrollment Period for all people with Extra Help status, regardless of whether they'll be assigned to a new plan in 2007, or end the private plan lock-in started in 2006.

Finally, Hayes' group calls for a guarantee from the federal government to reimburse states when they use the Medicaid program as a fall-back option for people with dual Medicare/Medicaid coverage when coverage is wrongly denied through the Part D plan.

The Medicare Rights Center has urged federal authorities to take immediate action and require that all Part D plans implement a transitional "safety net" for individuals dropped from the Extra Help lists until they have been successfully

re-enrolled. Hayes said it can take at least three to four weeks to be approved for Extra Help after an application has been submitted.

AVELLA WOULD CUT WATER, SEWAGE CHARGES: City Councilmember Tony Avella (D-Bayside), citing the constant pressure on fixed-income seniors from everincreasing living expenses, has introduced a resolution in the council to provide seniors aged 62 and older a 10 percent discount on water and sewer charges.

Avella stated: "Senior citizens continue to face ever-increasing expenses as a result of increased property taxes, overwhelming healthcare and medication costs and escalating costs for heating and transportation, yet most seniors are on extremely limited fixed-incomes and are in no positon to absorb these increases.

"Unfortunately, the city's water and sewer rates have incrased dramatically as well in the last few years, more than 26 percent since 2003, obviously worsening the situation for seniors."

Avella concluded, "Under these circumstances, providing a 10 percent discount on water and sewer charges will help seniors cope and allow them to use their limited financial resources towards more pressing needs such as medication and health care costs."