Drug Changes Are Looming, and Providers Seek Answers
By ROBERT PEAR

WASHINGTON, Dec. 18 - Two weeks before the start of the Medicare prescription drug benefit, pharmacists and nursing homes are desperately trying to find out who will pay for the medicines taken by hundreds of thousands of their residents.

The new law relies on private insurers to deliver drug benefits to older Americans. About two-thirds of the 1.5 million residents of nursing homes are participants in both Medicare and Medicaid. The government has randomly assigned them to private drug plans, regardless of their needs.

In many cases, nursing home officials said, they do not know to which plans their patients have been assigned. As a result, they do not know who will pay the bills or what drugs will be covered. Each plan has its own list of approved drugs, known as a formulary.

Becky A. Kurtz, the state-appointed ombudswoman for nursing home residents in Georgia, said: "We see a lot of confusion and a very steep learning curve for nursing home residents and employees. Many residents are not covered for all their medications under the plan to which they have been assigned."

By contrast, Ms. Kurtz said, "under the state Medicaid program, these residents have had nearly all their drugs covered."

Nursing home residents take an average of eight to nine medications a day.