Acting Governor Richard Codey

CODEY TO FEDS: YOUR ACTIONS UP TO THIS POINT ARE UNACCEPTABLE

With Weeks Left Until Deadline, Hundreds of Thousands of Seniors
Have Not Been Enrolled in New Medicare Drug Program

(TRENTON)–Acting Governor Richard J. Codey today defended New Jersey’s senior citizens, calling upon the federal government to take immediate action to ensure that the hundreds of thousands of applicants to the new Medicare Part D prescription drug program receive their new enrollment cards by the January 1, 2006 deadline so that prescription drug coverage is not disrupted for those who need it most.
In a letter sent today to Mike Leavitt, Secretary of the U.S. Department of Health and Human Services, Codey underscored the urgency and expressed New Jersey’s dissatisfaction with the manner in which the federal government has handled the application process for the new program.

“For two years President Bush has sung the praises of the new prescription drug plan. What good is this plan if it won’t be available to seniors when they need it?� said Codey. “The federal government’s actions up to this point are simply unacceptable.�

The Medicare Prescription Drug Improvement and Modernization Act was signed into law in December 2003 and regulations for the program were promulgated in January 2005. Since then, the state has submitted more than 100,000 Medicare Part D applications to the federal Centers for Medicare and Medicaid Services (CMS) on behalf of New Jersey’s State Pharmaceutical Assistance Program enrollees. This includes those enrolled in the Pharmaceutical Assistance for the Aged and Disabled (PAAD) and Senior Gold (SG) programs.

Over the last six weeks, CMS has only processed 700 of the 100,000 applications that have been submitted. New Jersey still has approximately 100,000 additional applications that need to be submitted to CMS. However the state has decided to exercise caution and withhold those applications until the current processing problems are addressed.

“Our PAAD and Senior Gold beneficiaries have enough on their minds trying to figure out how their new benefits work,� added Codey. “They should not have to worry about trying to obtain their prescription cards at the 11th hour. The federal government had promised a seamless transition to this new program and they have let our seniors down.�

The State Department of Health and Senior Services (DHSS) has repeatedly reached out to regional CMS officials to inquire about the problem. As of December 14, 2005, CMS officials assured DHSS that processing glitches had been rectified and that applications were now being processed. With just over two weeks remaining until the Medicare Part D program is supposed to go into effect, the state has seen little evidence that applications are being processed.

"New Jersey has worked hard to make sure our PAAD beneficiaries will have a seamless transition into the new federal program,� said DHSS Commissioner Fred M. Jacobs, M.D., J.D. “It’s frustrating to encounter delays at CMS that may jeopardize all the trust and good will that we have earned from our PAAD beneficiaries. We urge CMS to process New Jersey's enrollments as soon as possible."

Codey’s letter to Secretary Leavitt, dated December 16, 2005, is attached. A similar letter has also been sent to Dr. Mark B. McClellan, CMS Administrator.

December 16, 2005

Secretary Mike Leavitt
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

Dear Secretary Leavitt,

I am writing because I am concerned about the Centers for Medicare and Medicaid Services’ (CMS) delay in enrolling New Jersey’s Pharmaceutical Assistance to the Aged and Disabled (PAAD) and Senior Gold (SG) beneficiaries in the Medicare Part D program.

Our State Pharmaceutical Assistance Program (SPAP) has attempted to process Part D enrollments for our beneficiaries, but CMS has not approved the enrollment transactions. With implementation only two weeks away, New Jersey’s beneficiaries still have not received Medicare Part D enrollment cards.

Since the beginning of November, the State of New Jersey has submitted close to 100,000 Medicare Part D applications on behalf of New Jersey SPAP beneficiaries who seek enrollment in the Part D program. Over these last six weeks, CMS has processed only 700 of these applications. If there are glitches in the computer file transfers, they will now be magnified by the large volume of applications being processed. We will not be able to correct rejections and resubmit the transactions in time for a January 1 effective date. In addition, New Jersey is ready to submit an additional 100,000 applications, however, we have stopped submitting applications because of concerns that previous application batches have not been processed.
I am concerned that as January 1st is fast approaching, time is running out. The Prescription Drug Plans (PDPs) still need to produce and mail identification cards once the CMS approvals are obtained. Pharmacists still need to enter information from the ID cards into their point-of-sale software. Our SPAP will need to receive confirmation of the enrollments to enter the Medicare Drug Coverage PDP information on the SPAP claims processing system in order to coordinate the benefits. Ultimately, I am concerned that there is not enough time for all of this to happen, and that on January 1st some beneficiaries may be left without coverage.

I request your immediate attention to this matter. Please advise me of your plan to insure that New Jersey’s beneficiaries will be able to begin receiving benefits when the Medicare Part D program goes into effect on January 1st.

Thank your for your assistance.

Sincerely,

Richard J. Codey
Acting Governor