HHS has agreed to make changes to the Medicare Part D program to settle a class-action lawsuit filed on behalf of low-income seniors and disabled people who reported persistent problems getting prescription drugs.
Under the proposed settlement agreement, filed in U.S. District Court in San Francisco, the CMS would accelerate the Part D auto-enrollment process for beneficiaries who are dually eligible for Medicaid and Medicare, which the Government Accountability Office found takes a minimum of five weeks and often creates gaps in coverage. Drug plans and CMS regional offices, under the agreement, would be required to provide more help to beneficiaries whose information doesnt show up in plan or pharmacy computers as eligible for the low-income subsidy. Also, the CMS would launch an outreach campaign to educate pharmacists of changes to the system.
The lawsuit was filed in April 2006 by the National Senior Citizens Law Center and the Center for Medicare Advocacy, which received pro bono assistance from the law firm of Wilson Sonsini Goodrich & Rosati. The agreement is subject to approval by the court, which will retain jurisdiction to enforce it for three years. Because the agreement awaits final approval, the CMS would not comment on the substance of the proposed settlement, CMS spokesman Jeff Nelligan said in an e-mail. -- by Gregg Blesch