Impact of the Medicare Prescription Drug Benefit on Home- and Community-Based Services Waiver Programs

Surveying Maryland’s 3,180 dual eligibles who are enrolled in hcbs waiver programs, the author finds that the end-of-2005 transfer of prescription drug coverage from Medicaid to Medicare under the Medicare Modernization Act of 2003 could put these beneficiaries in jeopardy. The experience in MD is likely to be typical for other states. The paper recommends a number of federal policy remedies, including 90-day prescriptions, using open or shared formularies, & lengthening the enrollment period.