Washington, DC —
Senator John Thune (R-SD) today sent a letter to Dr. Mark McClellan, Administrator for the Centers for Medicare and Medicaid Services (CMS), requesting a detailed description of the steps that CMS will take to ensure that states and pharmacies recover expenditures due to administrative problems in the enrollment of dual-eligibles into the Medicare Part D program.
There are approximately 11,700 individuals in South Dakota currently on Medicaid who will now receive their prescription drugs through the Medicare Part D program. According to the South Dakota Department of Health and Human Services, about 50 percent of the dual-eligibles in South Dakota have experienced problems with their enrollment in Medicare Part D and it is estimated that about 25 percent will need the emergency funding provided by South Dakota.
"South Dakota has made every effort to ensure a successful transition for those seniors switching from Medicaid to Medicare Part D. It is only right for CMS to facilitate reimbursements for the state and participating pharmacies," Thune said. "I'm hopeful my request today will help to speed this process along, and I will continue to work to see that the state and its pharmacies are fairly compensated."
The text of Senator Thune's letter to Dr. McClellan is below.
January 24,2006
Mark McClellan, M.D., Ph.D.
Administrator
Centers for Medicare and Medicaid Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Dear Dr. McClellan:
I am writing to express my concern regarding timely reimbursement for the state of South Dakota as well as the pharmacies in South Dakota underwriting the cost of prescription drugs for people tmsitioning from Medicaid to Medicare Part D.
On January 17, the Centers for Medicare and Medicaid Services (CMS) offered to "facilitate" states' efforts for reimbursement by the drug plans participating in the Medicare Part D program. I appreciate CMS' offer to help states with their reimbursement and respectfblly request a detailed description of the steps that CMS will take to ensure that states and pharmacies recover expenditures due to administrative problems in the enrollment of dual-eligibles into the Medicare Part D program.
There are approximately 11,700 individuals in South Dakota currently on Medicaid who will now receive their prescription drugs through the Medicare Part D program. On January 9, Governor Rounds directed the South Dakota Department of Social Services to reimburse pharmacies for a 30-day supply of emergency medications for dual-eligibles experiencing problems with the new Medicare Part D benefit. About 50 percent of the dual-eligibles in South Dakota have experienced problems with their enrollment in Medicare Part D and it is estimated that about 25 percent will need the emergency funding provided by South Dakota. Governor Rounds estimates that this will cost the state of South Dakota approximately $300,000.
I understand that every new program implemented, especially one the size of the Medicare Part D program, will experience some administrative impediments. Pharmacies in rural areas such as South Dakota, however, cannot continue to provide prescription drugs without reimbursement. I appreciate CMS' efforts thus far to help remedy the difficulties associated with the Medicare Part D program and look forward to your response to my request. Thank you for your consideration.
Kindest regards,
John Thune
U.S. Senator
There are approximately 11,700 individuals in South Dakota currently on Medicaid who will now receive their prescription drugs through the Medicare Part D program. According to the South Dakota Department of Health and Human Services, about 50 percent of the dual-eligibles in South Dakota have experienced problems with their enrollment in Medicare Part D and it is estimated that about 25 percent will need the emergency funding provided by South Dakota.
"South Dakota has made every effort to ensure a successful transition for those seniors switching from Medicaid to Medicare Part D. It is only right for CMS to facilitate reimbursements for the state and participating pharmacies," Thune said. "I'm hopeful my request today will help to speed this process along, and I will continue to work to see that the state and its pharmacies are fairly compensated."
The text of Senator Thune's letter to Dr. McClellan is below.
January 24,2006
Mark McClellan, M.D., Ph.D.
Administrator
Centers for Medicare and Medicaid Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Dear Dr. McClellan:
I am writing to express my concern regarding timely reimbursement for the state of South Dakota as well as the pharmacies in South Dakota underwriting the cost of prescription drugs for people tmsitioning from Medicaid to Medicare Part D.
On January 17, the Centers for Medicare and Medicaid Services (CMS) offered to "facilitate" states' efforts for reimbursement by the drug plans participating in the Medicare Part D program. I appreciate CMS' offer to help states with their reimbursement and respectfblly request a detailed description of the steps that CMS will take to ensure that states and pharmacies recover expenditures due to administrative problems in the enrollment of dual-eligibles into the Medicare Part D program.
There are approximately 11,700 individuals in South Dakota currently on Medicaid who will now receive their prescription drugs through the Medicare Part D program. On January 9, Governor Rounds directed the South Dakota Department of Social Services to reimburse pharmacies for a 30-day supply of emergency medications for dual-eligibles experiencing problems with the new Medicare Part D benefit. About 50 percent of the dual-eligibles in South Dakota have experienced problems with their enrollment in Medicare Part D and it is estimated that about 25 percent will need the emergency funding provided by South Dakota. Governor Rounds estimates that this will cost the state of South Dakota approximately $300,000.
I understand that every new program implemented, especially one the size of the Medicare Part D program, will experience some administrative impediments. Pharmacies in rural areas such as South Dakota, however, cannot continue to provide prescription drugs without reimbursement. I appreciate CMS' efforts thus far to help remedy the difficulties associated with the Medicare Part D program and look forward to your response to my request. Thank you for your consideration.
Kindest regards,
John Thune
U.S. Senator