Posted At Bloomberg

The U.S. government told insurers to cover a 30-day supply of any drug that patients in the new Medicare drug plan were getting before the benefit started.

Insurance companies participating in the benefit also can't charge more than $5 for that supply of brand-name medicines for low-income participants. The Centers for Medicare and Medicaid Services, the Medicare agency, outlined the changes in a letter dated Jan. 13 to insurers and state Medicaid directors.

The agency acted after states including California and New York reported that people had problems getting drugs under the program, which covers both elderly and disabled Americans through subsidized private plans. About 22 million Americans have signed up for coverage, which began Jan. 1, including those eligible for Medicaid, the federal-state program for the poor.

``I am very concerned that a number of dual eligible beneficiaries have had difficulty in obtaining their prescriptions,'' Mark B. McClellan, director of the Medicare and Medicaid agency, said in the letter, first reported today by the New York Times.

Republicans and Democrats have complained about how the plan is being carried out. Medicare is subsidizing almost 3,000 different plans in 34 regions.

California said last week it will temporarily pay for the prescription drug costs of 1 million state residents. Governor Arnold Schwarzenegger, a Republican, will ask the federal government to reimburse the state for the estimated $70 million it will cost California. He ordered the state to pay for the drugs for five days and said he would seek legislation that would extend payments for another 10 days.

U.S. Senator Hillary Clinton, Democrat of New York and possible presidential candidate, said last week in a letter to program officials that people have been charged as much as $230 for their co-payment, or share of the drug cost.

Other States

Maine, New Hampshire, Vermont and North Dakota also have taken steps to help patients who have had problems getting their prescription drugs.

The Centers for Medicare and Medicaid Services said in the letter it is working to limit the cost to states and to make sure states are the payers of last resort.

Pharmacists have filled about 6.5 million prescriptions for Medicare beneficiaries at retail pharmacies in the first 10 days, according to a Centers for Medicare and Medicaid Services survey. An additional 3 million prescriptions were filled for beneficiaries in nursing homes.

Congress created the Medicare drug program, known as Part D, in 2003 to address seniors' concerns about drug costs that were rising more than 10 percent a year. The drug benefit is the biggest expansion of the Medicare program since Congress created it in 1965.