Few pharmacists seek state payments for incorrect charges

CLEVELAND - Only eight Ohio pharmacists have submitted claims for incorrect copayments under Gov. Bob Taft's offer to pay for glitches in the new federal prescription drug program for poor seniors.

The federal government is trying to address a problem that has caused some of the state's low-income Medicaid recipients to run into inflated copays, which were not supposed to exceed $5. State officials say some erroneous copays have been as much as $250.

Taft said last week that the state would continue to guarantee the difference to pharmacists through the end of the month, although the aid was supposed to end Feb. 1. The problem arose when federal computer systems misidentified some people as ineligible and charged the higher copays.

As of Thursday, pharmacists had sent claims for 14 patients and 72 prescriptions for less than $3,000 to the Ohio Department of Job and Family Services, spokeswoman Carmen Stewart said.

Ernest Boyd, executive director of the Ohio Pharmacists Association, said some pharmacists still don't know about the state's three-week-old offer or don't have the staff to do the paperwork.

Pharmacist Dave Miller, who works in downtown Cleveland, said he has read about the state's offer but hasn't submitted any reimbursement claims.

Miller said he's been calling doctors and asking them to switch to a drug with a lower copayment if a patient's contribution is too high. He said he didn't know seniors weren't supposed to pay more than $5 for any drug covered by their plan.

Susan Childs, a suburban Cleveland social worker, says she's frustrated that the problems are taking so long to fix.

"How can it be February and we are still not all on the same page?" she said.

Childs said she got prescriptions filled for seven clients Wednesday only after providing the state claim forms to three pharmacies.

Ohio is one of more than two dozen states offering the help until the glitches can be fixed.

The copay assistance is available only for those who qualify for both Medicare, the federal insurance for those older than 65, and Medicaid, the state-federal plan for the poor and disabled. Seniors must show both insurance cards to get the state-covered help from pharmacies.

Medicare participants chose coverage options from various plans, which are run by private insurance companies that contract with the federal government. The government subsidizes the cost of the coverage under the program that began Jan. 1.

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