Insight Matters
Winter 2006

Medicare Part D – Tracking and Reporting Problems

As many of you know, since January 1, 2006 many Medicare Part D patients with mental illnesses have not been able to access their medications - despite federal policies to ensure these individuals have access to all essential psychopharmacologic medications. Because Medicare Part D Prescription Drug Benefits now cover many Medicaid patients, these patients are at particular risk.

The APA is working diligently to address the concerns at a national level, and the Ohio Department of Mental Health is working to address local concerns.

Here’s what you can do to help the APA and ODMH make sure these potentially catastrophic medication access problems are addressed:

1. Collect as much information as possible - As you are hearing specific incidents, especially beneficiaries being turned away at the counter, obtain as much of the following information as possible:
   

   Beneficiary information (name, address, city, state, zip code, telephone number and/or email address);

   Medicare HICN (Health Insurance Card number);

   Prescription Drug Plan name;

   Pharmacy where incident occurred;

   Date of incident; and

   Nature of the complaint

2. Report the problem to the APA : Immediately report any and all problems your patients receiving the Medicare Part D benefit are experiencing accessing medications to the APA. Send an email describing any problems you or your patients have experienced to partd@psych.org or telephone the APA hotline at 866-882-6227. Also, complete the APA’s brief survey, “National Study of Medicaid and Medicare Psychopharmacologic Treatment Access and Continuity” if you receive it in the mail so we can systematically document these problems throughout the nation.
   
   Also, continue to check the following Web site for updates: http://www.mentalhealthpartd.org/
   
   
3. Report the problem to ODMH: Forward information to: MH_PARTD@mh.state.oh.us. This information will in turn be forwarded to our CMS Regional Office caseworkers for resolution.
   
   Also, seek out updated information at:
   http://www.mh.state.oh.us/medicaid/partd/medicaid.medicarepartd.html
   
   
4. Have your patients (or a family member) contact: their prescription drug plan directly, or call 1-800-Medicare or the Ohio Senior Health Insurance Information Program (OSHIIP) at 1-800-686-1578.

We need your help in documenting critical changes in medication access experienced by your Medicare Part D patients so that we can address these issues with policy makers, pharmacy plans, and service providers.

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