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January
31, 2006
ASSEMBLY AND SENATE PASS LEGISLATION TO COVER CO-PAYS FOR DUAL ELIGIBLES UNDER MEDICARE PART D – GOVERNOR MUST SIGN INTO LAW: Both houses of the legislature have now passed legislation sponsored by the respective Chairs of the Health Committees, Assemblymember Richard Gottfried and Senator Kemp Hannon, that would cover the co-payments required under the new prescription drug benefit for dual eligibles unable to make such payments. Under Medicaid, if an individual was unable to make a co-payment for a prescription medication, that person could not be denied access to the medication. However, under Medicare Part D, if an individual can’t make the $1-5 co-payment per medication required for people covered by the low-income subsidy, Extra Help, they can end up walking out of the pharmacy without any medications at all. We have now heard many stories of people who are on multiple medications with limited income are going without the drugs that keep them healthy and stable because the co-payments for all the medications are simply more than they can afford. In such a case, this legislation would allow the pharmacist to bill Medicaid for those co-payments that a dual eligible is unable to pay, thus providing access to the medications. Of course, MHANYS strongly supports the enactment of this legislation and is encouraging everyone to contact the Governor’s office to urge him to sign this legislation into law. Contact Governor Pataki to Urge Him to Sign the Bill to Cover Co-Pays for Dual Eligibles Unable to Make Payments (A.9462 / S.6410)Call
Governor Pataki at: Write
to Governor Pataki at: E-mail
Governor Pataki by going to:
LAST CHANCE TO STOP HURTFUL MEDICAID CUTS: Following in NMHA’s most recent Legislative Alert, urging everyone to contact their Members of Congress in opposition to the proposed Medicaid cuts that will be voted on tomorrow.
IN THE NEWS: Variations of the following article were also printed in the Albany Times Union, Schenectady Daily Gazette and Rochester Democrat & Chronicle Plan
would use temporary units to house violent sex predators. By
Candice Choi ALBANY, N.Y. -- Vacancies in psychiatric centers could soon serve as temporary holding stations for New York state's most violent sex offenders. Under the plan in Gov. George Pataki's budget proposal, $35 million would be set aside to create separate treatment areas in existing psychiatric centers in New York City, Marcy in central New York, Rochester, and Ogdensburg. The five sites would hold up to 623 sex offenders while a proposed 500-bed facility is built at the state's secure Camp Pharsalia in Chenango County. That facility would cost $130 million and open in 2009. An additional $27 million would be needed for staffing and operations of the temporary sites next year. "People would be moved into the (temporary) sites as they become available," said Martha Schaefer Hayes, chief financial officer for the Office of Mental Health. Absent new legislation, Pataki in September ordered state authorities to use existing mental health law to evaluate sexually violent predators in prison before their release to determine whether they should face civil confinement in an institution. So far, 41 inmates have been civilly committed at the Manhattan Psychiatric Center, the Kirby Forensic in New York City's Ward's Island and Central New York Forensic in Marcy. They are kept separate from patients. OMH has identified psychiatric centers where beds will become available until Pharsalia would open. An empty building near the St. Lawrence Psychiatric Center in Ogdensburg, for example, would be renovated to house up to 80 civilly confined child molesters and sexual predators through December 2006. Though the secure facility is on the outskirts of town, it is still less than two miles away from two elementary schools. Another empty building at the Mid-State Correctional Facility in Marcy would be fixed to hold 148 sex offenders through June 2009. "This is a misuse of the mental health system," said Michael Seereiter, of the Mental Health Association of New York State. The National Alliance for the Mentally Ill in New York State estimates there is already a waiting list of people for the 3,900 mental institution beds in the state. Mental health institutions are meant for short-term housing for people with diagnosed illnesses. The vast majority of sex offenders do not have mental illnesses, he said. Seereiter also pointed out there are vastly more convicted sex offenders than the new 500-bed facility could possibly house. There are currently about 5,300 inmates in the state who have committed sexually violent offenses; about 800 of them will be released from custody annually, with an equal number entering custody each year, according to OMH. "The only reason they're putting them there is that mental health law allows them to," said Harvey Rosenthal of the New York Association of Psychiatric Rehabilitation Services.
Drug
Plan Unfair to State Taxpayers. Editorial New York and other states should not have to bear the burden of paying for the mind-boggling problems plaguing the federal government's new Medicare drug plan. Washington should reimburse those states offering emergency aid to seniors caught in the plan's bureaucratic morass. Hundreds of thousands of elderly and disabled folks covered by the prescription-drug program have not been able to get their medicines since the new benefit debuted Jan. 1. The problems seem more acute for "dual-eligible" individuals who've had their drug coverage automatically shifted from Medicaid to Medicare. So New York and close to 25 other states enacted emergency measures to temporarily pay for prescription drugs for people eligible for both Medicaid and Medicare. It was the decent thing to do. But here's the rub: Taxpayers in New York and other states providing emergency coverage could end up paying for these drugs twice. State Medicaid programs are required under federal law to cover the cost of the drug benefit for dual eligibles by making set payments to Medicare, which administers the benefit. Yet the law prohibits Medicare from reimbursing states for emergency drug costs. It also prohibits Medicare from reducing its billings to the states. The federal government suggests that states recover the costs from the hundreds of private insurers that participate in the Medicare drug program. But that's clearly unworkable. States will waste even more money and time trying to chase them down. Sen. Charles Schumer, D-N.Y., and other senators from both parties have introduced legislation to correct this. Their proposed Medicare State Reimbursement Act would require the federal government to reduce states' payments to the Medicare program by the amounts they shelled out for emergency aid. The reimbursements would cover all state costs plus interest. The bill and similar legislation in the House deserve hearty support. No one expected the Medicare drug plan to start up without a few bumps in the road. All new projects experience problems. But so far, this road has been riddled with boulders. Mental-health facilities have been swamped with patients who've lapsed back into illness because they couldn't get their medications. Nursing homes stand to lose hundreds of thousands of dollars because residents were randomly enrolled in plans that don't cover all prescribed drugs or even contract with nursing-home pharmacies. And what fate befalls those people living in states that don't provide emergency aid? The new drug benefit is the biggest change in Medicare in 40 years. If serious deficiencies in its administration aren't corrected soon, it also could turn out to be one of the federal government's biggest fiascos. |
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