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Oregon Road Conditions & Cams Email Story to a Friend March 14, 2006 Donna Wyant of Talent picks up a prescription from Becky Jameson at the Talent Medicap Pharmacy for her husband, Richard. Like tens of thousands of other Oregon seniors, the Wyants have not yet enrolled in Medicare Part D. Doubts about Part D Seniors continue to worry about choosing a Medicare drug plan; pharmacist face delays being paid by providers By BILL KETTLER Mail Tribune Donna Wyant will choose a Medicare drug benefit plan for her husband before she picks one for herself. "I’m not taking any prescriptions right now," the Talent woman says. "He’s taking 12 or 13." Wyant and her daughter are still comparing plans to make sure they find the one that saves them the most money. "I just want to get some more understanding of what’s going on," she says. Thousands of other Oregon seniors have been slow to embrace Medicare Part D as well. Ten weeks after it started, nearly half of all Oregonians who are eligible still have not enrolled. Advertisement Of the roughly 547,000 Oregonians who qualify for drug assistance, about 243,000 (44 percent) have not yet signed up, according to data collected by the Kaiser Family Foundation. Seniors and others who have watched Part D take shape say some of the early start-up problems have been resolved, but new obstacles pop up each month with the latest batch of new enrollees. "We had huge problems at the beginning of January and huge problems at the beginning of February," says Jeff Harder, owner of Medford’s West Main pharmacy, "but it does seem like it’s starting to level out." While seniors are trying to choose their drug plan from dozens of options, pharmacists are trying to get paid. The companies that actually reimburse them (known in the medical world as "pharmacy benefit managers" or PBMs) have been slow to pay, pharmacists say. "It’s just killing our cash flow," Harder says. "We’re basically having to loan two months of bills out to these companies." "It’s the same thing as insurance companies dragging their feet in paying physicians," says Jim Thompson, executive director of the Oregon Pharmacy Association. "I know some pharmacists who have put medication out on a handshake," Thompson says, "but they can’t do that forever." Companies that distribute drugs to pharmacists expect to be paid within a specific term, usually 14, 21 or 30 days. Thompson says some pharmacists have taken out short-term loans to cover cash- flow problems. He says the delayed payments have hit small, independent rural pharmacies harder than large chains, which have more financial resources to back them up while payments are being processed. "It’s a tough time," he says, especially for pharmacists in remote little towns such as Lakeview, Fossil and John Day. Thompson says another crisis could develop April 1 when state support is scheduled to end for people who encountered difficulties getting expensive drugs and could not afford to buy them. The drug program created extra work for state and county workers when it began Jan. 1 because many of their medically fragile and low-income clients weren’t capable of applying on their own. Those initial difficulties seem to have been resolved, says Shannon Hickman, a Jackson County mental health nurse. "Once you get (a prescription approved) through Medicare, it seems to be working," Hickman says, but some people who were not supposed to need prior authorizations for their medicines are still being required to complete them. Since many can’t do the paperwork themselves, the burden falls to county workers, Hickman says. "It’s better, but it’s not perfect. I spent an hour (last Thursday) working on a prior authorization. "It still clearly has some things that need to be worked out." Medicare spokesman Michael Marchand in Seattle says new enrollees can make Part D work more smoothly by signing up early in the month. That gives insurance companies extra time to get each new client’s data loaded into computers before the drug benefit kicks in at the beginning of the next month. "Everything has to be confirmed and verified," before drugs can be dispensed, Marchand says. "Sometimes (the data) doesn’t get there in time." Seniors have until May 15 to enroll in a drug plan without penalty. After that date, they will pay an extra 1 percent of the monthly premium for each month that they fail to enroll. Marchand expects a surge of new enrollees as the deadline approaches. "There will be a lot of folks who will wait until the last month to make a decision." Reach reporter Bill Kettler at 776-4492, or e-mail Doubts about Part D ">[email protected] . Where to get help There are many sources of help for seniors trying to navigate Medicare Part D. Fifth District Congressman Greg Walden has organized a Medicare Part D workshop in Medford from 9 a.m. to noon on March 23 at the Reston Hotel, 2250 Biddle Road. There will be an educational workshop from 9-10:30 a.m. and one-on-one counseling for seniors who want help choosing one of the 45 drug plans. Volunteers at the Ashland Senior Center, 488-5342, are available on Thursdays between 10 a.m. and 1:30 p.m. by appointment only. The Retired Senior Volunteer Program at Rogue Valley Manor Community Services, 857-7780, provides assistance by appointment only on Wednesdays and Thursdays from 9 a.m. to 3 p.m. Help also is available at Rogue Community College’s computer lab in Medford’s Central Library on Tuesday, Wednesday and Thursday from 9 a.m. to noon by appointment. Call 857-7780. Information is also available on AARP’s Web site at www.aarp.org and the Medicare Web site at www.medicare.gov . 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