Meeting the Challenges of Medicare Drug Benefit Implementation

February 2, 2006

Thank you Chairman Smith and Ranking Member Kohl for providing this opportunity to discuss the Medicare prescription drug program.

As some of you may know, I am new to the Special Senate Committee on Aging. I feel honored and privileged to join my colleagues on the Aging Committee. I am eager to learn from them and eager to share the concerns of Coloradans with you.

Finally, I am excited to serve on the Aging Committee because it will allow me to highlight two important goals: tackling the health care crisis and shining a spotlight on rural communities.

As a product of Rural America, I am dedicated to assisting rural communities thrive. Like the rest of our country, Rural America is graying. Twenty-five percent of people living in rural Americans are Seniors. They face a number of challenges, including access to quality health care.
I look forward to working with my colleagues to ensure resources are available to all seniors, including those in rural America.

As the President noted in his State of the Union speech this week:
“Our government has a responsibility to help provide health care for the poor and the elderly.”

I agree – and I look forward to continuing to work in a bi-partisan manner with my colleagues in the Senate to do just this.

While I was not in the Senate when Congress passed the Medicare Modernization Act, I am confident that Congressional leaders had these same priorities in mind.

As Colorado’s Attorney General, I followed the debate and am learning from my colleagues—but more importantly from Coloradans—about the challenges facing Seniors who are applying for Medicare Part D.

I have received many questions as well as stories about this new program from my Colorado constituents.

Many have contacted me about the complexity of the program. In Colorado we have 17 companies providing 42 plans to Medicare beneficiaries. It is easy to see how the task of picking the right plan is daunting for beneficiaries.

The implementation of the program has posed problems in Colorado, as it did elsewhere in the country. Many of the approximately 60,000 “dual eligibles” in the state have had difficulty getting their prescriptions.

In the first few days of the program, many of the pharmacies did not have the correct information – and turned these individuals away or ask them to pay the same payments required of all beneficiaries. Some scrounged together or borrowed from friends and family to pay the deductible and co-pays. Others went without.

I know several states stepped in to assist these individuals and agreed to pay the pharmacies to get people their needed drugs. However, Colorado was not one of these states.

I applaud these states and urge CMS to work diligently with the states to reimburse them for the costs they have taken on.

Another issue which concerns me is the issue of payments to the pharmacists.

In my native San Luis Valley there are perhaps one or two pharmacists in the different towns. These pharmacists are often the center of health care for the community, especially for the elderly. If they hurt, the community hurts.

I have heard from pharmacists who are paying the up-front costs of the CMS requirement that “pharmacists must provide a 30-day supply of drugs to dual eligible beneficiaries” – to be paid back by the plan the beneficiary is enrolled in.

Placing the burden on these pharmacists risks the livelihood of their businesses. I urge CMS to ensure that each pharmacist is paid quickly and accurately. These communities need these pharmacists, and we must keep these businesses strong for them.

Finally, with all of the challenges the Medicare Part D program has faced since its creation, I worry about the May 15th deadline for enrollment in the program.

If we really want to ensure that all eligible Americans can access this program, we must seriously consider extending the deadline. If we wait to act, many will be left behind in the bureaucracy.

Again, I thank the Chairman and Ranking member for holding hearing.

I appreciate the panelists, the Department, the Centers for Medicare and Medicaid, and the Social Security Administration for their work on this issue and look forward to hearing more from all.

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