By By Steve Gillespie / staff writer
June 21, 2004
In an effort to save money, about 65,000 Medicaid beneficiaries were notified this month that they will no longer be eligible for prescription drug coverage under Medicaid.
Instead, they will have to rely on Medicare or other sources to help pay for their medicine something several recipients fear they may have a tough time finding or may not be there at all.
Dr. Warren A. Jones, executive director of the Mississippi Division of Medicaid, talked about that and other issues in an interview with The Meridian Star editorial board.
Jones is a family physician and retired U.S. Navy captain.
He is a professor of health policy and clinical professor of family medicine at the University of Mississippi Medical Center. And he is an assistant professor of family medicine at Howard University School of Medicine in Washington.
The Meridian Star: Is there a real crisis in Medicaid regarding prescription drugs, or is it, as the governor has suggested, an information inadequacy?
Warren A. Jones: I think the governor hit the nail on the head: We missed an opportunity to get ahead of the curve by supplying information before people became excessively afraid.
We knew there exists resources out there to help people get their health care. We know we can provide a way of helping people to learn how to access those resources. The problem is that the fear factor was generated so excessively that by the time they turned for assistance, it was a deluge. Everybody was calling at the same time.
A report from June 7 to June 11 showed 15,000 phone calls into our Medicaid offices across the state. And this is in the midst of us doing everything else for our beneficiaries enrolling. If we had had a way to team with our civic partners and news media partners to roll out an educational program in a less hostile and excited environment, I think people would have known where to turn.
When you start taking elderly people and disabled people and you scare them and you tell them, Your safety net is gone and you're going to fall,' that's cruel and inhumane. The reality is we're asking if you're eligible for Medicare, to get your care from Medicare right now because the state doesn't have the money and we're going to provide the resources to help you figure out how to get that care.
The Star: You mentioned there was a lost opportunity to supply information. Did you not know this was coming? Were you taken by surprise?
Jones: I did not anticipate such energized, intentionally disruptive opposition. I had already told the staff I will go around the state and meet with the newspapers and community leaders and civic groups and ask for their help in educating people. That's what we planned to do. But when this furor started, we never had the chance. I was not prepared for that. I was prepared to couple with the Mississippi State Extension system, the faith-based communities, the Kiwanis and Rotary Clubs. That's what I was prepared to do, so it did catch me off guard.
The Star: Would it have been better from your standpoint if the Legislature had allowed more time before the changes started rather than July 1?
Jones: I had no argument with the July 1 day. What I did have a problem with was having to spend all my time responding to calls from folks in your industry, responding to points that were misleading and often times untrue.
The Star: Some program beneficiaries who received letters notifying them that their Medicaid prescription coverage would stop have complained that their was not enough information in the letter to help them get assistance elsewhere. What is your office going to do to better inform people?
Jones: What we had planned to do all along was this the letter could not be made all-encompassing. We had a legal requirement to notify people of the change of status. We gave them a contact number for information, and we gave them a small packet of some representative places where they could turn for care. If we had made it anymore voluminous than that it would have been overwhelming.
We said (to) call the regional offices. The volume of calls was so dramatic because of the fear, I hadn't even had a chance to train our offices on how to respond to those things because the demand became instantaneous.
Over a normal period of time our resources would have been there to respond. But because of what I call almost hysterical response of people who were legitimately frightened, it really challenged us.
The Star: What kind of help are you looking for?
Jones: What I would like to do is ask the physicians, nurse practitioners and physicians assistants, individuals in hospitals, pharmacists and other nurses to serve as learned individuals to help our elderly and disabled to learn how to function in the Medicare system.
Here's the bottom line: They have to be in that system, if they are eligible, by January 2006 anyway because the federal government has said it will no longer pay both Medicaid and Medicare for people who are eligible for Medicare. It's going to happen, so we're trying to put the infrastructure in place today to take care of that.
I've met with leaders in the state medical society, they've been supportive. They know where we're trying to go. The leaders of the hospital association, the pharmacy associations, the nursing home associations have been supportive. But there's a distance between the leadership and the rank-and-file members. We need (the media's) help in filling that gap.