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Read: Medicare may owe you

Published May 8, 2007


WASHINGTON - Some low-income seniors might have missed out on millions of dollars in federal subsidies because the government did not notify them that they could be reimbursed for past prescription drug purchases when they enrolled in Medicare's drug benefit, a Government Accountability Office study has found.

The problem is one of several that have complicated the enrollment of nearly 7-million "dual eligible" - people who qualify for both Medicare and Medicaid - according to the study, which is being released today.

It can take more than a month for a senior who newly qualifies for Medicaid, which provides health care to the poor, to be enrolled in a heavily subsidized prescription drug plan offered by Medicare. But by law, the person must get coverage retroactive to when they became eligible, sometimes as long as several months before.

Medicare paid insurers $100-million last year to provide that coverage. However, until March of this year, the federal Centers for Medicare and Medicaid Services did not inform the beneficiaries that they could seek reimbursement for drugs bought during the retroactive period, the GAO found.

More than 400, 000 beneficiaries could have been affected, according to congressional staffers.

"Given the vulnerability of the dual-eligible beneficiary population, it seems unlikely that the majority of these beneficiaries would have contacted their (plan) for reimbursement if they were not notified of their right to do so, " GAO investigators wrote.

In a written response to the GAO, Leslie Norwalk, acting CMS administrator, objected to the "overwhelmingly negative tone" of the findings.

The Senate Finance Committee will examine this and other problems at a hearing today.

[Last modified May 8, 2007, 01:47:36]

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