By now, everyone has read and heard enough about the new federal Medicare prescription drug plan that kicks in this coming January to be completely confused. A couple of weeks ago, I wrote about the advisability of seeking help from the experts – local senior citizen centers and the state Department of Social Services – to choose the best prescription plan for you from among the many available. As I write this column, the General Assembly is in the process of passing legislation to ensure that this new federal program will be smoothly implemented here in Connecticut.

      This legislation HB 7702, An Act Concerning Implementation Of The Medicare Part D Program, was passed unanimously by the House of Representatives a few weeks ago and, as I write this, is pending action by the Senate. Of course, I will vote for this bill when it comes before us.

The bottom line is that people who are on Medicare, but whose incomes are low and they also qualify for Medicaid (Title 19) will not have to pay copays or deductibles for their medications, even if the drug is not on a federal formulary list. And, everyone who is enrolled in ConnPACE will automatically be enrolled in the new Medicare Part D unless they wish to select their own plan.

      Here are some of the highlights of the legislation, as explained by the analysis prepared by the General Assembly’s Office of Legislative Research. The bill, which takes effect upon final passage:  

• Requires the state to pay the federal copays for full benefit Medicare-Medicaid dually eligible people – that is, those eligible for all Medicare benefits who had previously also received all their prescription benefits through Medicaid. The bill does not cover special groups that received limited Medicaid assistance only with their monthly Medicare premiums and their co-insurance.

• Establishes a “Medicare Part D Supplemental Needs Fund” to help beneficiaries who are also ConnPACE participants or full benefit Medicare-Medicaid dually eligible and cannot pay for medically necessary non-formulary drugs. Among other things, it also authorizes the Department of Social Services to set conditions and procedures for this assistance.

• Deletes the Department of Social Services’ authority to make ConnPACE clients, in certain situations, responsible for paying the difference between what DSS pays for a drug on the plan’s formulary and the price of the drug above the usual $16.25 copay.  

• Gives ConnPACE recipients and applicants an opportunity to consult with the commissioner, or her designated agent, about Medicare Part D plan selection before choosing one.

• Allows the DSS commissioner to establish a mail order option for all drugs under Part D plans.

Connecticut has been working to provide access to medicines for many years.  This legislation merges our ConnPACE and Medicaid programs with the new federal benefit, and everyone wins.  I continue to urge constituents to call CHOICES or 211 for more specific information about Medicare Part D.
As always, I am happy to answer your questions and respond to your concerns about this and other issues important to our state. I can be reached at the Capitol at 1-800-842-1421 or you can send me an e-mail at Catherine.Cook@cga.ct.gov.