Print Page

Utah, Medicare complete transition to new drug coverage

"Utah will no longer need to use its Medicaid systems to pay for Medicare drug coverage, a testament to the partnership between the state and the federal government during the first weeks of the new drug coverage," said Health and Human Services Secretary Mike Leavitt.

"Governor Huntsman and Utah Medicaid officials worked closely with us to make sure the transition to Medicare drug coverage went as smooth as possible, and this partnership has helped Medicare beneficiaries get their coverage more quickly," Secretary Leavitt said.

"States such as Utah that took steps with Medicare and pharmacists to use Medicare's billing systems whenever possible ended up with few or no claims, and their beneficiaries are now using Medicare coverage," said Centers for Medicare and Medicaid Services Administrator Mark B. McClellan.

Utah and 44 other states, plus the District of Columbia, were participating in the demonstration program designed to limit costs for Medicare beneficiaries who are also in Medicaid.

Under the program, Medicare will reimburse states by reconciling drug payments with prescription drug plans, and by paying any differential between the drug plan reimbursement and Medicaid costs, as well as state administrative costs.

The program also includes "best practices" for states to help their pharmacists and beneficiaries avoid the need for state billing, by using Medicare systems effectively and resolving cases in a timely way.

Many of the states approved for the demonstration have either none or very few claims. Other states with significant Medicare populations - South Carolina, Michigan and Iowa - never applied for the demonstration project at all.

As of March 15, because of individual circumstances unique to them, 12 states will continue to use their systems in limited circumstances for up to several more weeks. Many of these states have already substantially reduced their use of their state claims systems.

The states continuing in the program are: Arkansas, Arizona, California, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Texas, Vermont, and Wisconsin. Medicare will continue to pay administrative costs for a short period of time for other states in the program, including the District of Columbia.

Print Page