Medicaid Back-Up for Medicare Part D to Continue
August 1, 2006
Author: Trilby de Jung
The New York Medicaid program will continue its wrap around coverage for dual eligibles, those eligible for both Medicaid and the new Medicare Part D drug program, until January 1, 2007. This means pharmacists can still bill Medicaid when a Part D plan refuses to pay because a prescribed drug is not on the formulary or for other reasons. Dual eligibles are also eligible for Part D’s Extra Help program, which eliminates the donut hole and keeps co-payments down to either $1 generics/$3 brand names (for those with income at or below 100% of the federal poverty level) or $2/$5 (for those above 100% of FPL).
In other good news from the final days of the legislative session, spousal refusal will continue to be available in New York, transfers of assets will not be penalized for home care services or assisted living and cost-sharing will not be increased in Family Health Plus. New York has implemented the federal changes to institutional long term care that are required by federal law (the Deficit Reduction Act). The Department of Health has just released a new ADM detailing changes in how the penalties will work for transfers of assets for Nursing Home and Lombardi care, visit the Online Resources Center at http://onlineresources.wnylc.net/pb/showquestion.asp?faq=90&fldAuto=2045
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