Advocates Call on Legislature to Stop Proposed Rx Cuts to the Elderly and Poor

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Wed Jan 28, 2009 1:58pm EST

Governor's Budget Eliminates EPIC and Medicaid Wrap Coverage for Prescription
Drugs

ALBANY, N.Y., Jan. 28 /PRNewswire-USNewswire/ -- Members of the New York State
Medicare Part D Coalition, including AARP, the Empire Justice Center, Medicare
Rights Center, The Legal Aid Society, Selfhelp Community Services and
Statewide Senior Action, called on the New York Legislature today to reject
the Governor's proposed budget cuts to programs that help the elderly and poor
pay for the prescription drugs they need. 

The Governor's Budget proposal would eliminate more than $50 million in "wrap
around" coverage provided through the Elderly Pharmaceutical Insurance
Coverage (EPIC) Program and Medicaid programs for drugs not covered by the
federal Medicare program.  This proposal could negatively impact hundreds of
thousands of low-income and elderly New Yorkers who rely on these programs to
help pay for the medication they need. 

The current Medicaid wrap pays for four specific categories of drugs --
atypical antipsychotics, anti-depressants, anti-retrovirals used to treat
HIV/AIDS, and anti-rejection drugs used by organ and tissue transplant
recipients -- when a Medicare prescription drug plan refuses to cover them.

These budget changes contradict the state's assurance last year that the
elderly and poor would not go without the medication they need. 

"AARP strongly believes that no one should walk away from the pharmacy counter
without the prescription drugs they need," stated Lois Aronstein, AARP New
York State Director.  "With these changes, the state is shifting the cost and
burden onto its most vulnerable populations."

"New York's Medicaid wrap provides a critical safety net to New York's poorest
and most vulnerable Medicare beneficiaries -- organ transplant recipients and
people living with mental illness or HIV infection," says Cathy Roberts, a
senior paralegal with the Empire Justice Center.  

"Right now CMS' hotline is overwhelmed with Part D complaints, even when EPIC
continues to provide a safety net for New York's seniors.  We shudder to think
of what will happen if EPIC slams its doors shut," said David Silva, Assistant
Director of the Evelyn Frank Legal Resources Program at Selfhelp Community
Services. 

"Every year, the Medicare Rights Center receives calls from thousands of
people with Medicare who have tried to appeal for Medicare Part D coverage on
their own, but find that the process can be challenging, even impossible, to
navigate.  New York should protect EPIC enrollees by ensuring access to
medically necessary prescriptions when they are not available under Part D and
by helping enrollees through the Medicare appeals process," stated Dina
Wizmur, Deputy General Counsel for the Medicare Rights Center.  

"In less than three months, New York already saved $500,000 to the EPIC
program by winning appeals against Part D plans and forcing the plans to pay
for drugs. This system, negotiated in last year's budget, should be given a
chance to work for the State and vulnerable seniors," said Lisa Sbrana,
Supervising Attorney of The Legal Aid Society's Health Law Unit.

"Many of New York's most vulnerable seniors will be very surprised and angry
to find out that their drugs are no longer covered by EPIC. Rather than
seeking alternatives, many will try to pay out of pocket; others will stop
taking their scripts. Neither of these options is acceptable," stated Justin
Cunningham, Executive Director of Statewide Senior Action. 

According to the Center for Studying Health System Change in Washington, D.C,
one in seven Americans under age 65 went without prescribed medicines in 2007.
 In addition, three in 10 low-income Americans said they had been unable to
fill a prescription because of cost, and nearly one in four adults on Medicaid
or in a state insurance program said they were having difficulty affording
their medication.

AARP's Public Policy Institute Watchdog Report has documented that drug
companies have substantially raised prices on 220 brand name prescription
drugs over the past few years.  The Rx Watchdog report found that prices of
brand name drugs raised an average of 7.4 percent in 2007 -- nearly two and a
half times the rate of general inflation.

AARP New York has over 2.6 million members. AARP is a nonprofit, nonpartisan
membership organization that helps people 50+ have independence, choice and
control in ways that are beneficial and affordable to them and society as a
whole. AARP does not endorse candidates for public office or make
contributions to either political campaigns or candidates.  We produce AARP
The Magazine, published bimonthly; AARP Bulletin, our monthly newspaper; AARP
Segunda Juventud, our bimonthly magazine in Spanish and English; NRTA Live &
Learn, our quarterly newsletter for 50 + educators; and our website,
www.aarp.org. AARP Foundation is an affiliated charity that provides security,
protection, and empowerment to older persons in need with support from
thousands of volunteers, donors, and sponsors. We have staffed offices in all
50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.



SOURCE  AARP New York

Kristin Legere, +1-518-447-6723, or Bill Ferris, +1-518-447-6712, both of AARP
New York
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