California Could Lose About $200M Annually Under Medicare Drug Benefit
The new Medicare prescription drug benefit could cost California $215 million annually, according to an estimate by the Department of Health Services, the Sacramento Bee reports.
Initially, Congress said state prescription drug costs would decrease by 10% when the Medicare drug benefit takes effect in January 2006 in part because people who are eligible for both Medi-Cal and Medicare would receive prescription drug coverage through Medicare.
However, Stan Rosenstein, deputy director of medical care at DHS, said a department estimate indicates that the benefit will cost the state money. However, Rosenstein said that the cost is decreasing as talks with federal officials continue.
Rosenstein said, "We've gone from a 10% saving to a new cost to the state. This is a moving target. We continue to do more data analysis and refine our numbers as we learn more and more of the rules of the program."
CMS Administrator Mark McClellan said federal officials will continue "to make sure we get the numbers that get the state to come out ahead. That is the intent of the law."
State officials also have voiced concern that state residents switching from Medi-Cal to Medicare for prescription drug coverage could become confused and might miss medications. According to the Bee, dual eligibles could face increased drug copayments or find that one of their medications is not covered by the Medicare drug plan.
Rosenstein said that state officials have requested permission from federal officials to allow dual eligibles to maintain access to the same medications during the first six months of their enrollment in a Medicare drug plan.
McClellan said that Medi-Cal in December could authorize 90-day prescriptions for dual eligibles (Weaver Teichert, Sacramento Bee, 5/8).
Additional information on the Medicare drug benefit is available online.