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North Dakota to Help Medicare Drug Beneficiaries


When the federal government's widely anticipated prescription drug plan went into effect at the start of this month, the reviews from patients and pharmacists were swift and scorching. Across the country, a pattern of problems emerged. Patients were overcharged or turned away by pharmacists who could not verify coverage. Phone lines set up to offer help were overwhelmed and, in the end, offered only busy signals. Thousands of seniors and the disabled were unable to get their prescriptions filled. The problems have prompted governors in nearly a dozen states to take emergency action to make sure people can get the drugs they need. North Dakota Governor John Hoeven is one of them.

Governor JOHN HOEVEN (Republican, North Dakota): What we're asking pharmacists to do when someone comes in who is Medicaid eligible to try to apply for the reimbursement through the federal Part D program, but if they hit a glitch or a problem, do not turn that senior down as far as filling the scrip. Go ahead and fill the scrip. And then if you need to, go ahead and bill the state under the old Medicaid system and we'll work to get reimbursement from the federal government.

NORRIS: And you'll do this until January 23rd? Is that correct?

Gov. HOEVEN: Right. We set up a transition period until January 23rd when pharmacists can apply under the former Medicaid system. Now at that point, we'll review it and see how things are going. But the key is, you know, we want to get these people transitioned to the new Medicare Part D program, but we want to make sure their scrips are filled during this transition period. And that's why we're providing the assistance.

NORRIS: How much is this costing the state?

Gov. HOEVEN: Well, it's too soon to--you know, I mean, it could cost us several million dollars. That's a guestimate so far. We don't know what the ultimate cost will be, but again, this is reimbursement that the federal government is obligated to make under the program, and so we anticipate being able to work with them so that the state will obtain that reimbursement from the federal government.

NORRIS: How many people in North Dakota qualify for this program?

Gov. HOEVEN: As far as our Medicaid population, it's between 10 and 11,000.

NORRIS: And so North Dakota will pick up the bill for Medicaid patients who are mistakenly denied coverage. What about Medicare patients who've enrolled in the new system, show up at the pharmacy and discover that their name is left off the role?

Gov. HOEVEN: Right. And obviously that's a much bigger number. So what we've done there is through our insurance department in the state of North Dakota, we have what's called the Senior Health Insurance Counseling program, and that's a program where we have volunteers throughout the entire state who will work with seniors to get them enrolled in the best program for them under Medicare Part D. So we've got that group statewide out there that's working with seniors. And what they're doing now is for any seniors that encounter difficulty in getting their scrips is we've asked them to call either our insurance department or what we call our SHIC program, which is the State Health Insurance Counseling Program. And we get volunteers out to work with those seniors to get them enrolled and get them reimbursement for their medications.

NORRIS: As the state was gearing up for this transition, did you warn the federal government that this might be a problem?

Gov. HOEVEN: Well, we worked very diligently to get our information to the federal government so that we could make this transition effectively prior to January 1 to insure that all our Medicaid eligible individuals get their prescription drugs. We had that information to them by October. Actually we then went back, along with our Long Term Care Association, and worked to make sure that seniors were enrolled in the right program under the private payer that fit their individual needs. So we did all that work prior to January 1. What we found out, as I said, is the problem is that the federal government in delivering that information from their computers to the private payers, that's where they've hit the problem. This resulted in this difficulty.

NORRIS: Governor, you're a Republican. Some of the governors who've also taken emergency action are Democrats, and in some cases, they view this as an opportunity to point out problems that the current administration, Republican administration, is having in administering this program. Since you are a Republican, does this put you at all in an uncomfortable position to take this action?

Gov. HOEVEN: You know, I think we still have to recognize that the Medicare Modernization Act provided a prescription drug benefit for everyone over age 65. And there is a real benefit there to our citizens nationwide. Yes, this is a difficult transition. And, yes, states are having to step up and help. But the key is that we work with the federal government to get reimbursement and that we make sure that we make this transition and get this benefit to our seniors as intended.

NORRIS: Governor, thank you so much for talking to us.

Gov. HOEVEN: All right, Michele.

NORRIS: That's was North Dakota governor, John Hoeven. He was speaking to us from his office in Bismarck, North Dakota. Transcript provided by NPR, Copyright NPR.