Two weeks into the new Medicare prescription drug program, many of the nation's sickest and poorest elderly and disabled were being turned away or overcharged at pharmacies, prompting more than a dozen states to declare that they would pay for the lifesaving medicines.

In response to complaints about how the new program is working, the Bush administration over the weekend ordered health insurers to provide a 30-day supply of prescription drugs to any beneficiary who previously received them, The New York Times reported today.

The administration also said poor beneficiaries cannot be charged more than $2 for generics and $5 for brand-name drugs.

The action came after several states announced that they were declaring health emergencies and would pay for drugs that should have been covered by the Medicare program.

Ohio and Wisconsin announced on Friday that they would cover drug costs for low-income seniors who would otherwise go without, joining Massachusetts and the other New England states, as well as California, Illinois, Pennsylvania, Arkansas, New Jersey, North Dakota, South Dakota, and New Jersey.
Massachusetts officials announced last week that they would guarantee prescription payments.

Up to 6.4 million low-income seniors, who until Dec. 31 received their medications for free, suddenly found themselves navigating an insurance maze of large deductibles, copayments, and outright denial of coverage.

Computer glitches, overloaded telephone lines, and poorly trained pharmacists were blamed for mix-ups that have produced the unintended consequences. Many low-income beneficiaries of both Medicare and Medicaid who enrolled in the new program found that they were not on the government's list of subscribers, and many insurers said they could not identify poor people who needed help.

''This new prescription drug plan was supposed to be a voluntary program to help people who didn't have coverage," said Jeanne Finberg, an attorney for the National Senior Citizens Law Center. ''All this is doing is harming the people who had coverage, America's most vulnerable citizens."

Hailed as Bush's signature domestic achievement, the program, which began Jan. 1, offers drug coverage for the first time to 43 million seniors and disabled Americans eligible for Medicare. At the same time, 6.4 million low-income beneficiaries who were receiving their medications through state Medicaid plans were switched into Medicare for drug benefits and told they would not be charged the standard $250 deductible and copayments.

But interviews with two dozen state officials, pharmacists, advocates for the elderly, and individual clients revealed a host of problems. Many poor seniors were never enrolled or were enrolled in plans that do not cover their medications. Others received multiple insurance cards, creating confusion at the pharmacy. Some were charged the deductible and copayments well beyond what they could afford. And some, such as Laurine League, left empty-handed.
''For years, I've had no problems, going to the same pharmacy," said League, 49, a Queens, N.Y., woman with severe mental illness. ''The pharmacist told me one drug was going to cost $198. I don't have that kind of money."

The states that have stepped in to help have already incurred several million dollars in unexpected drug bills, but Mark McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said he did not have the authority to reimburse them. He urged states, pharmacists, and providers to work with his agency to collect reimbursement from private insurance companies administering the prescription program.

Acknowledging that some of the 6.4 million low-income beneficiaries known as ''dual eligibles" have been overcharged or denied medication, McClellan said: ''That is simply not acceptable. We have been working around the clock and around the country to make sure those beneficiaries get the prescriptions they need."

Governor Arnold Schwarzenegger of California, a Republican, said his state would spend up to $70 million to provide two weeks' worth of medicine, but he said he expects reimbursement. ''While I am confident the federal government will resolve the problems with this transition, these people need our help now," he said, ''and we're going to be there for them."