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New Yorker's Prescription Plight Reaches Congress

June 26, 2007

The Bush administration's Medicare Part D drug plan has faced a rocky road over its 18-month life span, and many people have faced prescription nightmares, including one New Yorker whose story is on its way to Congress. A 56-year-old New Yorker named Elaine has diabetes, asthma, and needs supplemental oxygen, but when she changed to a new Medicare coverage option, her drug plan got lost in the shuffle. Greg Otten with the Center for Independence of the Disabled stepped in to help, and was told that she could get her medication, but not until after a two-day delay.

“When people have chronic conditions that require pills to be taken every day, how can you possibly have a rule that says they can have two days to resolve something like that?”

Otten says Elaine's case is typical of those now being reviewed by the House Ways and Means committee. The committee is holding the hearings to figure out why these problems are still happening 18 months into the program and how it can work better.

Otten believes the system is just too complicated, leaving New Yorkers like Elaine at the mercy of their local pharmacist who can choose to step in, as hers did, when Part D failed to cover her.

“What justification is there for creating any of these issues where medications run out and consumers have to rely on the good will of their pharmacist?”

David Silva is a staff attorney with Self Help Community Services, which has worked on 200 cases in just the last year where New Yorkers had to fight to get their proper drug benefit.

“If there is a problem, the fact is you've got at least two different people you have to call. So if you can't get through to the plan, you're going to have to call CMS, and then they're going to be calling somebody at the plan trying to get them to do their job. The problem is having too many cooks in the kitchen.”

Michael Clifford/Eric Mack, Public News Service - NY