Pharmacists Prohibited From Giving Medicare Advice

Nov. 18, 2005 — -- Don't be surprised if your pharmacist can't provide much help for choosing a new Medicare prescription drug plan, because 172 pages of federal guidelines for Medicare Part D prevent them from instructing seniors on which plan to choose.

The concern is that health care providers might disregard their patients' needs and choose a plan with the highest reimbursement to doctors and physicians. Instead, health care providers only are allowed to discuss basic information and then must refer a patient to 1-800-Medicare or www.medicare.gov for more detailed information, said Barbara Cebuhar, a spokesperson for the Centers for Medicare and Medicaid Services.

Cebuhar insisted that seniors shouldn't have any problem getting in touch with someone that can help. In an email to ABC, she said the department has more than 10,000 staffers and volunteers helping enroll seniors across the country.

Seniors are listening. More than 408,000 people called the hotline on Wednesday. But for people who can't or don't want to use the hotline or Web site, turning to a pharmacist or doctor would be a natural next step in choosing a plan.

However, to the ire of some pharmacists and industry groups, they are prevented from helping in most cases, as highlighted by the extensive Final Part D Marketing Guidelines.

While it's unclear how these guidelines will be enforced, pharmacists say it makes an already complicated situation even more challenging, especially since some states have close to 100 drug plans available.

This is a critical issue for the pharmacists who work for nursing homes and assisted living centers, according to the Long Term Care Pharmacy Alliance. This week, the alliance sent a letter to President Bush and congressional lawmakers asking for looser restrictions on counseling.

As they point out, a typical nursing home resident is "84 years of age, suffers from eight different diseases and is on nine medications at any given time," stated an alliance press release. Many older adults have cognitive disorders, as well.

Pharmacist Stuart Beatty said he understands why the restrictions are in place, but said he's not sure if the guideline helps patients much.

"This would not be a problem except seniors will go to pharmacists -- the most accessible health care professionals -- to get information about the plans," said Beatty, of Ohio State University's College of Pharmacy.

Pharmacist Allen Nichol said that many pharmacists have gone through multiple training courses on the Medicare D plan. He is director of the Grandview Family Practice's Diabetes Management Program in Columbus, Ohio.

"Basically, the pharmacist has been asked to help the Medicare recipients, but the (the government is not) allowing pharmacists to help patients select the best plan," he said. "How the patients receive the best guidance will be limited."

The restriction applies to physicians, as well. Dr. Richard G. Roberts, a professor of family medicine at the University of Wisconsin, said that even if he could provide advice, he doesn't have the time to explain the intricacies of the plan.

Patients "may need a financial planner to help them through this," he said.