Even before the Medicare discount prescription card program debuted on May 3, local pharmacists suspected that the initiative would be unhealthy for them. While seniors could save money with the new cards, independent pharmacists would lose a disproportionate share of revenues because of the discounts and lower dispensing fees. 

But many of these pharmacists received a shock last week. They found that the Medicare Web site says that their stores accept discount cards for which they never signed contracts. On top of that, pharmacists found stores that no longer exist listed as discount card network participants. Worried about the confusion such misinformation will cause, they've flooded the state pharmacists society with e-mails and phone calls, documenting scores of errors on the site. 

No smooth operation 
"This is just not going smoothly," says Sally Landsberg, supervising pharmacist at Town Drugs, near Columbia University. 

Her store is listed as accepting more than 20 cards. "That's just great, since I never signed up with any of them," she says. 

Some pharmacists believe that the misinformation came from card sponsors that have contracts with certain pharmaceutical wholesalers, which are automatically enrolling all pharmacies they supply. A spokesman for the Centers for Medicare & Medicaid Services says that the Web site lists information that card sponsors supplied to the government, and that details will be fixed if they are erroneous. 

Damage done 
But the damage may already be done. New York pharmacists are fighting proposed cuts to their Medicaid reimbursement fees in the governor's budget, and they are worried that the phantom contracts weaken their negotiating position by making it appear that they have agreed to even worse reimbursement contract terms from discount card sponsors. They also fear that they will lose business from longtime customers who have been misled into signing up for cards that their drugstores won't accept. 

"To show that the card program has all these providers is just false," says Anthony Caserta, owner of Alleon Pharmacy in Bay Ridge, Brooklyn, which is listed as accepting 11 discount cards but has signed only one contract. He also found his now-shuttered Edward's Drug Store on East 57th Street listed, accepting eight cards. 

The pharmacists who signed contracts with Medicare card sponsors agreed to accept deeply discounted reimbursements in order to participate in the program. Some 1 million elderly New Yorkers are eligible for the prescription discount cards, which they can start using in June. The Medicare cards give seniors discounts of 10% to 25% off retail prices for many medications. 

Because of the concerns over fee reductions, many independent pharmacists have not signed on with card sponsors, while others limited the number of networks they joined. 

These business owners are incensed over the false listings, and their timing. 

Reimbursement fight 
The executive budget calls for cutting reimbursements to pharmacists participating in Medicaid and in the state's own discount drug program for seniors, the Elderly Pharmaceutical Insurance Coverage program, known as EPIC. But even these onerous terms are more generous than Medicare card sponsors' rates. 

"We are in tough negotiations, and this has our people furious," says Craig Burridge, executive director of the Pharmacists Society of the State of New York. "We don't want the governor's office to say, `You are taking these discount cards, so why aren't you taking these cuts?' " 

Pharmacists also worry about the impact on their customers. While seniors might sign up for a card because the Medicare Web site mistakenly says that their pharmacy accepts it, they can switch cards only once a year, according to the program's rules. Therefore, they may be forced to patronize a drugstore that actually is in the network, but is less convenient for them. 

EPIC appeal 

Frustrated by the federal discount program, many pharmacists are enrolling in EPIC instead. New York offers generous benefits to seniors, and the reimbursement rates to pharmacists are now more attractive than those under the federal program.