Lawmakers question Tenncare’s ‘Safety Net’ drug program
The complaints have led a number of lawmakers to question the state paying $11.4 million to St. Louis-based Express Scripts to provide the drug program — some of whose services are offered free through nonprofits and other venues.
“It’s just not working as smoothly as we would have liked,” said Sen. Don McLeary, D-Humboldt. “I don’t want to be too critical, but the way it sounded was everybody would be automatically enrolled and it would be a smooth process to get their medicine. That isn’t the case.”
The state hired Express Scripts in July to provide free or discount drugs for several months to 191,000 people cut from the TennCare rolls — cuts Gov. Phil Bredesen has said were necessary to bring costs under control.
Lawmakers, however, did comply with Bredesen’s request to set aside $104 million to provide a “soft landing” for those cut. About half that money has been set aside to fill prescriptions for those losing TennCare.
When contacted by The Tennessean, Express Scripts referred questions to the state.
State officials say Express Scripts has told them they’re seeing many more errors in the applications from former TennCare enrollees than from their other customers. Such errors — which include misaddressing letters to the company and incomplete forms filled out — add up to delays in delivering some drugs, they say.
“We’ve heard some concerns, and we’ve been troubleshooting,” said Laurie Lee, a state Finance Department official who oversees the company’s contract. “We’re satisfied. We think Express Scripts is a very good partner.”
Mary Linville, a nurse who works in a clinic in rural Macon County, say patients have tried to order medicines through Express Scripts but find they can’t. Some patients placed an order for free generic drugs through the company last month, but have not gotten them, she said.
“I can’t find anyone to fix this,” said Linville. “They won’t die right away. But I don’t understand why they can’t get the drugs that are supposed to be out there.”
Some lawmakers have pointed out the state is paying Express Scripts to enroll people in a generic-drug program that is readily accessible for free to people around the country.
Plus the company is linking people to drug manufacturers’ free or low-cost programs, which is a service many nonprofits offer for free.
State Rep. Charles Curtiss, D-Sparta, said lawmakers believed the company was being paid to provide a seamless transition to many people coming off TennCare.
“The way it was described to us the process would be seamless,”Curtiss said. “People would just get the drugs they needed. But after the contract was executed it turned out it wasn’t seamless at all. People are having to jump through all sorts of hoops.”