Suit Seeks To Block Automatic Enrollment of Dual Eligibles in Medicare Drug Plans
Two Pennsylvania advocacy groups have filed a lawsuit that asks the U.S. District Court in Philadelphia to block automatic enrollment of thousands of individuals dually eligible for Medicare and Medicaid into Medicare prescription drug plans when their medication coverage switches from Medicaid to Medicare on Jan, 1, 2006, the Pittsburgh Post-Gazette reports. The lawsuit, filed last week, names CMS Administrator Mark McClellan and HHS Secretary Michael Leavitt as defendants and alleges that the federal government does not have the legal authority to automatically enroll more than 110,000 Pennsylvania dual eligibles into Medicare prescription drug plans.
The Philadelphia office of the Pennsylvania Health Law Project and Community Legal Services of Philadelphia filed the lawsuit, which seeks class-action status, on behalf of several Pennsylvania dual eligibles, the Action Alliance of Senior Citizens of Greater Philadelphia and the Center for Advocacy for the Rights and Interests of the Elderly.
According to the lawsuit, the automatic enrollment of dual eligibles into Medicare prescription drug plans could "unfairly deprive them of access to their medical providers" because the plans could limit members to a network of providers, the Post-Gazette reports. In addition, the lawsuit alleges that a letter sent by CMS to inform dual eligibles about the switch from Medicaid to Medicare prescription drug coverage was "incomplete, inaccurate and misleading."
CMS spokesperson Peter Ashkenaz said that he was not aware of the lawsuit but added that CMS has implemented measures to protect dual eligibles (Fahy, Pittsburgh Post-Gazette, 12/6).
Additional information about the Medicare drug benefit also is available online.