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Retirees tell Middletown council prescription plan change raised copays, privacy concerns
Summary
Multiple retirees told the City of Middletown in a public hearing that a March 1 change to the city's prescription contract increased out-of-pocket costs, required confusing 90-day fills, and forced claim paperwork to the risk manager's office, raising HIPAA concerns; the mayor said the director for risk management apologized and the item will remain on the agenda for follow-up.
During the council’s public hearing, several retirees described unexpected increases in prescription costs and difficulties after a contract change they say took effect March 1.
Hope Casper told the council she believes the change violates her retirement contract and asked that the proposed agenda change be rejected. "That change violates my retirement contract," she said. Kathy Kennedy, who identified herself with a background in health insurance, described speaking with CVS and said members are now paying ‘‘double’’ on some co-pays because Express Scripts is processing claims differently; she said some members were told to obtain 90-day fills and that the city did not proactively reprocess claims or refunds. Kennedy also raised a procedural concern: she said claim-review directions required claimants to provide receipts to the risk manager’s office, which she said could be a HIPAA violation if pharmacy information was exposed.
City officials acknowledged implementation problems. The mayor said the director for risk management had apologized for the implementation issues and that the council will leave the item on the agenda for additional follow-up next month to address outstanding questions and any further problems that arise.
In a related public comment, Eamon Wisniewski, speaking for the Russell Library, urged the council to address an ongoing chiller failure at the library that briefly pushed upstairs temperatures to about 87°F and limited the building's ability to serve as a summer cooling center. He said the feasibility committee has cost estimates and warned that state funding opportunities could be time-limited, strengthening the need to resolve facility issues ahead of any referendum.
Council members did not take final action on prescription coverage at the meeting; the mayor said staff will continue to correct implementation problems and the item will remain on the agenda for the following month.
