Diabetes patients miss out on mail program

Just 2,800 of the 7,000 affected Medicaid patients have switched to a new mail-order service.

By WES ALLISON

© St. Petersburg Times,
published November 6, 2001

On paper it's an easy sell: Save Florida taxpayers $1.5-million a year, while ensuring low-income diabetes patients get medicine delivered to their door.

In practice, however, a new program requiring diabetic Medicaid patients to get their drugs and insulin through the mail likely will cause some patients to go without, at least initially, some advocates say.

And as of Monday, when the new program took effect, just 2,800 of the 7,000 affected patients had been switched over to the mail-order system, causing confusion at some pharmacies.

"Somebody calls in and says, "I need my medication.' I call them back and say, "I can't fill it. Did you get enrolled in this?' ' said John Kelley, owner of the Apothecary in Gulfport, which has 30 to 50 diabetes patients on Medicaid. "And they say, "Enrolled in what?' I tell them they should have gotten a letter."

Medicaid is the state health insurance program for the poor. Beginning Monday, the state Agency for Health Care Administration required Medicaid recipients to get diabetes medication, blood-sugar testing equipment and insulin through Health Alliance, a mail-order outfit in Fort Lauderdale, rather than at walk-in pharmacies.

The switch is expected to save the state about $1.5-million a year, said George O. Kitchens, chief of Medicaid pharmacy services for the Agency for Health Care Administration. It's the first of what likely will be more changes in how the state provides medications to poor people with chronic diseases.

Pauline Ellis, director of programs and advocacy for the American Diabetes Association in Florida, said her group has not received any complaints, but "any change in the system in the way they've been doing it is going to be a challenge."

Helen King, a registered nurse who works with the diabetes education program at the Florida Heart and Vascular Institute in St. Petersburg, agreed. But many diabetics like getting drugs through the mail because it's convenient.

"It is key having supplies available and medications available on time, consistently," King said. "If it comes reliably and they know to expect it, it actually could be better."

The state Legislature approved the change last year, and the Agency for Health Care Administration sent letters to affected patients, their pharmacies and physicians, Kitchens said. But he acknowledged problems are likely at first.

Patients not yet enrolled with Health Alliance can get an emergency supply of medication from their pharmacy, he said. Pharmacists also are supposed to give them a toll-free number to call to enroll.

"I think it's going to be a challenge," Kitchens added. "It's going to take a lot of effort from everybody -- pharmacy providers trying to help . . . physicians being involved, and Health Alliance in how they contact and follow up with these patients."

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