"I don't know how Oregon will successfully do this in this timeframe," Dr. Tina Kitchin, Medical Director of Oregon's Department of Human Services, told the U.S. Senate Special Committee on Aging. Kitchin said the state spent a full year moving its Medicaid population into managed care programs in the 1990s, but under the current rules, will only have several weeks to make the coming transition.
A key problem, she
said, is that many of those eligible for both programs will be unable to use the internet or Medicare's
toll-free information lines to figure out which plan will work best for them.
A high proportion of those who will have to make the transition from Medicaid to Medicare drug coverage "have cognitive impairments, ranging from developmental disabilities and psychiatric illnesses to dementia, which not only make these choices almost impossible, but also make those tools irrelevant," she
But Clark and Kitchin
said McClellan's assurances that the new Medicare plans will have to have "transition policies" to protect patients whose Medicaid-covered drugs are not on their approved lists, did not satisfy them.
In Oregon, many managed care plans do more than required, said Kitchin
, but "we also have plans where it's a struggle to get them to do the minimal," and she
expects the same range from Medicare drug plans.