Under a decision by the U.S. District Court in San Francisco, the most vulnerable low-income elders and those with disabilities will no longer be subject to extensive delays in obtaining prescription drugs under Medicare Part D or having to prove they are eligible for the program's low-income subsidy (LIS).
"The Bush administration has agreed to make significant changes to its administration of the prescription drug benefit for low-income beneficiaries," according to the National Senior Citizens Law Center (NSCLC), which filed the class-action lawsuit, Situ v. Leavitt, along with the Center for Medicare Advocacy. NSCLC filed the case against Michael Leavitt, secretary of the U.S. Department of Health and Human Services, on behalf of 6.2 million low-income Medicare beneficiaries, who are dually eligible for Medicaid.
Plaintiffs argued that poor information management by the Centers for Medicare and Medicaid Services (CMS) created ongoing barriers for low-income people struggling to obtain prescription medications. When Congress enacted the 2003 Medicare prescription-drug law, it entitled impoverished beneficiaries to receive the LIS. These beneficiaries were to be automatically enrolled into a Part D plan so they could purchase prescription medication for a nominal charge.
The system proved dauntingly complex for these beneficiaries and, NSCLC staff attorney Kevin Prindivflle observed, "These individuals have faced life-threatening delays in receiving vital medication. …