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Feds nix SeniorCare, say Doyle admin failed to provide info

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The federal government has told Wisconsin that if it wants to continue the state's SeniorCare program it will have to do it without federal funds.

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The acting director for the Centers for Medicare and Medicaid Services (CMS) says that the lower than projected participation in the program along with a failure by Gov. Jim Doyle's administration to provide required information were the reason behind the move.

Doyle, however, put the blame on President Bush.

"The Bush administration has made it impossible for Wisconsin to continue the SeniorCare program," Doyle said.

The decision means that Wisconsin seniors would need to start using the Medicare Part D prescription drug program after June 30. Wisconsin is the only state not using the Part D program.

In a March 30 letter to Wisconsin newspaper editors, Leslie Norwalk, acting CMS administrator, said that SeniorCare has only enrolled 52 percent of the people it originally projected.

She noted that because of the low enrollment the state is paying only half of its projected cost and that it could use the money it is saving to fund beneficiary premiums and cost-sharing under the Medicare plan.

"This would cost the state less than the original $100 million it originally committed to the program," Norwalk said in her letter.

A CMS spokesman says that many states have developed Part D wrap-around programs which are basically a state-funded Part D supplement which helps pay cost-shares for low-income Part D participants.

"Through the combination of Medicare Part D and a state wrap-around you can catch more people who are now falling through the cracks," said Bob Herskowitz.

He added that with the wrap-arounds the Part D program is very effective at keeping user costs low.

CMS also says that the Doyle administration failed to provide the information needed for CMS to determine if Wisconsin's SeniorCare program was budget-neutral to Medicare.

In a letter delivered Wednesday to Doyle, Norwalk says the state failed to provide information about who was using SeniorCare the agency can't tell if the program is budget neutral.

Norwalk added that identifying the population which is served by SeniorCare is a fundamental requirement.

"When we worked with CMS in 2005 they had a definition for budget neutrality and we met that definition, but somewhere along the way they (CMS) changed the definition because they wanted to kill the program," said Carla Vigue, a Doyle spokesperson.

Norwalk also asserted that the Doyle administration failed to outline how SeniorCare participants who qualify for a low-income subsidy would be moved to the Medicare Part D program.

She also said the state failed to make sure there is a smooth transition for seniors to the Part D program, because it didn't consider a request by the agency to consider a "wrap-around" program.

Doyle answered that his administration has been working since 2005 to develop a wrap-around program, but that not a single private insurer was willing to participate.

"Twenty-one states provide a wrap-around benefit to supplement Part D, thereby providing many models for Wisconsin to draw upon," Norwalk said in her letter.

She added that her agency would be able to extend the deadline for seniors to switch to Part D until Dec. 31, 2007, if Wisconsin would provide some type of transition program.

Vigue says that the administration is working on getting the extension.

"The main thing is that we provide a smooth transition for Wisconsin seniors," Vigue said.

One local lawmaker took issue with the Doyle administration's failure to provide the information.

"I have serious concerns by comments contained in the letter citing a failure by the Doyle administration to 'submit critical information' necessary for consideration of Wisconsin's request for an extension, despite repeated requests," said Rep. Kitty Rhoades, R-Hudson.

She added that she will work with members of the Legislature to ensure that the federal government gets the information they need.

Brady Bautch is the Internet Publisher for the RiverTown Newspaper Group. He can be contacted at internet@rivertowns.net

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