Publications: Ask The Legal Expert - February 2006

Because it is so new, I'm worried that families might get angered with Medicare Part D fallout. How can we best react to any complaints?

As the Medicare Part D program begins, facilities should keep up to date on program developments and state and federal responses to problems.

As the facility is not responsible for problems caused by Part D or the Part D drug plans, your best response to residents or family members IS to act as a resource. You should provide the resident or relative with whatever information IS available that can address the specific complaint.

For example, residents who were eligible for full Medicaid services in addition to Medicare services ("dual eligibles") may complain they have access to fewer prescription drugs or that their co-payments have increased. It IS possible dual eligibles could qualify for state assistance Facilities can refer residents to their local area agency on aging. For further assistance, call (800) 252-8966.

For residents who are not dual eligibles, you can prepare a fact sheet detailing the basics of the application process and provide contact information for drug plans that cover the facility's region. Do not advocate for the Part D program or any plan.

Facilities can always direct questions and complaints to the Medicare Part D program (800) MED-ICARE. You should also have contact information for the Part D drug plans in your region should any complaints require a response from the resident's drug plan.

Reproduced with permission from McKnight's Long-Term Care News

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