The federal Centers for Medicare and Medicaid Services has assured New Jersey that it has resolved all deficiencies and the systems are in place to provide prescription drug coverage for those eligible under the new program. Based on these assurances, the state has developed a plan to gradually transition payments back to Medicare Part D.
The specific implementation schedule is listed below:
• Tuesday, March 14: Southern Counties: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Ocean, Salem
• Tuesday, March 21: Central and North Central Counties : Hunterdon, Mercer, Middlesex, Monmouth, Morris, Somerset, Union
• Tuesday, March 28: Northern Counties: Bergen, Essex, Hudson, Passaic, Sussex, Warren
The new federal drug program, Medicare Part D, began January 1, 2006 and, within days, the state responded to failures in the plan by covering medications that should have been paid for by the federal government.
“Secretary Mike Leavitt has assured me that the U.S. Department of Health and Human Services will reimburse New Jersey for the millions we've spent to provide medication for people who fell through the cracks in the new federal drug program,” said Governor Jon S. Corzine. “The state is ready to help our seniors, the disabled and other vulnerable populations in New Jersey if the federal government has not fixed the system adequately.”
Deficiencies in computerized eligibility lists and other system problems led to pharmacies not having accurate records of who was covered under the new federal drug program. As a result, the State of New Jersey stepped in to cover the prescription drug costs for Medicare clients who also receive Medicaid, state Pharmaceutical Assistance to the Aged and Disabled (PAAD) and Senior Gold.
As of March 9, New Jersey has paid more than $70 million on claims for dual eligibles, or people who receive their health coverage from both the federal Medicare and the state Medicaid programs. For PAAD and Senior Gold clients, New Jersey has paid $86 million, ensuring that no patient left a pharmacy without life-saving medications.
In June 2005, New Jersey appropriated $20 million to cover co-pays and medications that are not on the approved prescription drug lists in the Part D plans for the 146,000 dual eligibles. PAAD will continue to provide wrap-around coverage for those costs not covered by Part D.
Consumers should continue to use their Medicare Part D prescription plan cards at their pharmacies in order to get their medications.
The Department of Human Services' Division of Medical Assistance and Health Services, which administers the Medicaid program, can assist people with questions via the toll-free NJ Medicaid hotline at 1-800-356-1561. The Department of Health and Senior Services, which administers the PAAD and Senior Gold programs, can assist people with questions via the toll-free hotline at 1-800-792-9745.
