Wisconsin: Feds deny SeniorCare waiver

Wisconsin: Feds deny SeniorCare waiver

	Published : Wed, 04 Apr 2007 21:04 By : Agencies Print this Story

MADISON, Wis. (AP) - Wisconsin's unique prescription drug program may be allowed to stick around through the end of the year, but only if state officials agree to convert it at that time into something that will work alongside the federal Medicare Part D.

In a letter sent to Gov. Jim Doyle dated Tuesday, an official with the federal Department of Health and Human Services denied Wisconsin's request for a waiver to keep the SeniorCare program beyond June 30.

Leslie Norwalk, acting administrator of HHS's Centers for Medicare and Medicaid Services, said in the letter that the department was disappointed that the state has not converted to a so-called wraparound program that would work in conjunction with Medicare Part D.

The state also did not provide 'critical information' for HHS to use to evaluate the savings produced by continuing SeniorCare, Norwalk said.

HHS is willing to work with the state to create a program to supplement Medicare Part D, she said. If Wisconsin agrees to that, then SeniorCare may be extended through the end of the year, she said.

Doyle scheduled an afternoon news conference and had no immediate comment on the waiver not being extended. The state's director of Medicaid, Jason Helgerson, said last week that Wisconsin would work on a wraparound program if its waiver was not extended. Twenty-four states already have such programs.

Helgerson did not immediately return a message seeking comment Wednesday. Senate Majority Leader Judy Robson, D-Beloit, said the decision was a win for big pharmaceutical companies and a loss for taxpayers and senior citizens.

Robson said the fight to continue SeniorCare will go on, but the federal government had offered a 'glass of poison to our seniors' by requiring a wraparound program to be created for SeniorCare to continue through the end of the year.

'They have a gun to our head,' she said.

There are 104,000 seniors over age 65 on SeniorCare, which started in September 2002.

The decision to deny the waiver was expected. Last week, Norwalk said it was 'highly unlikely' the federal government would grant the waiver. The Bush administration has argued the Medicare Part D prescription drug benefit makes SeniorCare unnecessary.

But supporters claim the state program that uses a mix of state and federal money is easier than Medicare Part D to negotiate, saves seniors money on prescriptions and is more cost-effective for government.

Under SeniorCare, seniors get prescription drug coverage for $30 a year, with four levels of copays and deductibles based on income. Under most Medicare Part D plans, there is a monthly premium, a $265 annual deductible and varying copays.

The state Department of Health and Family Services says SeniorCare costs the federal government $617 per year per person, while its subsidy for Medicare Part D costs $1,174 per participant.

'It is unfortunate that the (Bush) administration did not honor Wisconsin's request, supported by the state's entire congressional delegation, to be kind to our elders by granting a waiver extension to the most successful prescription drug program in America -- SeniorCare,' said U.S. Rep. Steve Kagen, D-Wis.

Of SeniorCare's $155 million cost this year, state taxpayers pay about $57.6 million with $53.6 million coming from the federal government and $44.1 million coming from price rebates negotiated with drug companies.

Wisconsin was one of five states granted a waiver to keep its prescription drug program running, and it is the only one that has not either stopped such a program or converted it to complement Medicare.

Now that the federal government has made its decision, it is imperative that Wisconsin lawmakers create a supplement to Medicare Part D to ensure that no one has a disruption in their medications, said Jim Flaherty, associate state director of AARP Wisconsin.

'We are counting on the governor, the state Legislature and the Joint Finance Committee to sit down together and find a way to support this program,' Flaherty said.

Tom Frazier, executive director of the Coalition of Wisconsin Aging Groups, said he remained hopeful that the state's congressional delegation could pass legislation to continue the program or have state policymakers find some other way to mitigate the damage. He didn't think a supplemental program would be well-funded enough to ensure seniors don't pay more for medicine than they do now under SeniorCare.

'That's our goal: To see that nobody's worse off,' Frazier said. 'But it's easier said than done.'

Associated Press Writer Fred Frommer in Washington, D.C., contributed to this report.