'D' IS FOR DECISION: RETAIL'S ROLE IN MEDICARE PART D

The Medicare Part D prescription drug benefit has certainly endured its share of recent controversy. Democrats have lambasted the plan as an inordinately confusing, bureaucratic handout to the pharmaceutical industry, while fiscal conservatives in both parties have derided the benefit's astonishing multibillion-dollar price tag.Earlier this year, regular news reports surfaced recounting horror stories

The Medicare Part D prescription drug benefit has certainly endured its share of recent controversy. Democrats have lambasted the plan as an inordinately confusing, bureaucratic handout to the pharmaceutical industry, while fiscal conservatives in both parties have derided the benefit's astonishing multibillion-dollar price tag.

Earlier this year, regular news reports surfaced recounting horror stories of small-town pharmacists forced to pay for patients' prescriptions and seniors getting trapped in a maze of paperwork after inadvertently signing up for two or more incompatible plans.

Yet, as the May 15 deadline for signing up eligible patients nears, the program appears to be earning a quiet show of support. The American Association of Retired Persons released a survey in April indicating that 78% of seniors enrolled in a plan said they were satisfied. In a similar ABC News/Washington Post poll, 41% of all respondents said they disapproved of the program, but by contrast, almost two-thirds of enrolled seniors viewed the plan favorably.

Those favorable viewpoints may be due in no small part to Medicare education events - including those hosted at thousands of supermarket pharmacies. These deserve a great deal of credit for making the transition to the new plan work so smoothly for many seniors.

Giant Eagle, for example, began offering free Medicare open houses and one-on-one counseling sessions in October 2005. In January, the Pittsburgh-based retailer began pairing Medicare-eligible customers with trained advisers at in-store computer terminals through a program developed with My Medicare Matters - a nonprofit group created by the National Council on the Aging and the Access to Benefits Coalition.

The service was kicked off by a special event at a Pittsburgh location featuring former Pirates Elroy Face and Bob Friend. And the company has continued to promote counseling efforts this year using a combination of print campaigns, in-store signage and word-of-mouth from in-store pharmacists.

"Well before the new Medicare program went into effect, the folks with our Giant Eagle Pharmacy understood that many of our customers might experience difficulty adjusting to the new program," said Dan Donovan, the supermarket's spokesman. "Wanting to make our customers' lives as easy as possible, we made a conscious effort to proactively assist these customers with their transitions to the new program."

Donovan said the most frequent questions raised by participants have involved which plan to choose and whether there is the possibility of switching plans at a later date. Based on an individual's situation, these one-on-one meetings may take anywhere from a few minutes to an hour, but they typically end with a customer enrolled in a plan that is a good fit for their particular prescription needs and financial situation.

Similarly, the Osco and Sav-On pharmacy divisions at Albertsons hosted information tables at more than 1,000 locations during the initial enrollment period, and have informational literature available at each of their locations.

"Our goal with that has been to provide seniors with as much information as we possibly could," said spokeswoman Karen Ramos. "We had signs and brochures in every store during the initial enrollment period up until Jan. 1, 2006, and following that, we have set up a Medicare information center in every single pharmacy in the company."

The pharmacists at each location underwent an "extensive certification and training program to give them the tools to answer patient questions," Ramos said, adding that, given Albertsons' very large network of stores, they have continued to play a critical role in coordinating informational events at the local level.

"It has been our goal to work with the governmental agencies if there are opportunities," Ramos said. "Local agencies often contact the pharmacies at their local stores, and our pharmacists have been told that if there is an opportunity to partner with a bona fide program or governmental agency, then we want to do that."

Meanwhile, the pharmacy services department for Osco and Sav-On has stayed in close touch with the U.S. Centers for Medicare and Medicaid Services, obtaining new information as it becomes available and sending it to store pharmacists to keep them up to date.

Although the May 15 deadline for enrollment is fast approaching, an estimated 14 million eligible beneficiaries were not yet enrolled in a plan, according to official estimates.

"The challenge our pharmacists continue to face is getting the necessary Medicare-related information to those customers who need it, but are not aware that they need it," said Donovan of Giant Eagle.

There will doubtless be stragglers in need of advice, as well as customers who turn 65 after the deadline and will need help during the Nov. 15-Dec. 31 enrollment period later this year. Also, CMS recently granted an indefinite deadline extension for patients eligible for low-income coverage. As a result, several advocacy groups plan to continue working to build awareness among the general senior population during the next several months.

"I don't think that the need to do outreach is going to end," said Scott Parkin, spokesman for the NCOA and My Medicare Matters. "There's going to be a pool of people that will be difficult to reach, difficult to convince and difficult to enroll."

Due in part to challenges such as these, Osco/Sav-On has also begun offering feedback to CMS, Ramos said.

"We've just continued to communicate with them to let them know what we're seeing and the questions that we're getting from customers, in order to help them make this the best program it can be," she said.

Online Resources For Medicare Part D:

www.medicare.gov/pdphome.asp

The U.S. government's official Medicare Prescription Drug Program site. This consumer-oriented site includes a straightforward set of links to a Medicare prescription drug plan finder, an enrollment center, and outlines of common situations and things to consider, among other resources.

www.cms.hhs.gov/PrescriptionDrugCovGenIn

U.S. Department of Health and Human Services site. It offers many resources for health care providers and pharmacists, including landscapes of local plans in Excel format, FAQs regarding processing claims for dual eligible beneficiaries, Medicare Part B vs. Part D guidance, and POS-facilitated enrollment FAQs.

www.mymedicarematters.com

A consumer site sponsored by the National Council on the Aging and the Access to Benefits Coalition, both nonprofit organizations. The site includes very simple, step-by-step tools to help seniors select the best Medicare Part D plan based on factors such as their current prescriptions and existing drug coverage.

www.mentalhealthpartd.org

This site, hosted by a group of state and national psychiatry associations, offers resources specifically tailored to Medicare Part D plans as they relate to psychiatrists, psychiatric drug providers and consumers of psychiatric prescriptions.

www.thedesk.info/PartD/index.htm

Compiled by the Disability Policy Collaboration, this site offers news, information and other resources tailored to developmentally disabled and other "dual eligible" Medicare Part D beneficiaries with disabilities.