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Broward & Duval Beneficiaries Receiving Important Mail

Attention Medicaid beneficiaries in Broward and Duval counties: Don’t toss out the bright lime green and blue envelope in your mailbox sent by the Agency for Health Care Administration (AHCA). It contains valuable information about new health care plans that are accepting new members under the state’s Medicaid reform pilot project.

The brightly colored literature includes a list of HMOs and provider service networks, their benefits and co-payment information. Eleven plans in Broward County and four in Duval County are enrolling beneficiaries under the pilot project.

At this point, AHCA has sent these materials to 10 percent of Medicaid recipients in these counties as part of a seven-month enrollment period. You should receive your envelopes 30 days before your annual Medicaid renewal date.

Children with chronic conditions, foster care children and individuals with developmental disabilities are not required to enroll in a health care plan at this time. Mandatory enrollees are low-income individuals and families, SSI recipients, the elderly and disabled.
 
Mandatory enrollees will not have to pay monthly insurance premiums – the state will pick up the tab. 
 
Health care coverage will begin Sept. 1 for those beneficiaries who select a plan by Aug. 18. Those who haven’t enrolled by then will receive a reminder notice on Aug.30 and have until Sept. 21 to make a choice. After that, the state will assign them to a plan. Benefits will begin Oct. 1 for this group, according to AHCA officials.

The state is offering choice counselors to assist Medicaid beneficiaries in selecting a health care plan. The number is 1-866-454-3959 (TDD 1-866-467-4970). Hours are 8 a.m. to 7 p.m., Monday through Friday, and 9 a.m. to 1 p.m. on Saturdays.

Florida CHAIN OP ED in Sun-Sentinel

MEDICAID REFORM: Major changes occurring with little attention
By Andrew Leone
July 31, 2006

Medicaid reform, pursued by Gov. Jeb Bush and approved by the Florida Legislature in special session last December, is here amid no discernible fanfare and the apparent lack of interest on the part of the media. Touted as a way to control Medicaid spending while providing beneficiaries with a wider array of choices in services, reform entails moving users from Medicaid (the health care safety net of last resource for low-income Americans) to private managed care plans. 

In its first year, reform will affect over 130,000 Medicaid recipients in Broward County. By 2011, all 2.2 million Medicaid beneficiaries in Florida may be enrolled in managed care plans. 

Although the official start date for reform was July 1, media have taken no notice. In Broward, not even articles announcing the installment of Alan Levine (former secretary of the Agency for Health Care Administration) as the new CEO of the North Broward Hospital District mention his role as major architect of the reform plan. 

To advocates who work on behalf of Medicaid beneficiaries, and to many beneficiaries themselves, this silence is cause for concern. Considering the revolutionary nature of Medicaid reform, one would hope that those charged with implementing it are not making preparations for a possible Category 5 storm of Medicare Part D proportions by hoping the public will just look away. 

In passing reform, the Florida Legislature wisely mandated not to expand it beyond the "pilot" counties without prior legislative approval, to be based upon an evaluation. A Medicaid Reform Advocates Coalition, comprising Florida CHAIN and other organizations that work on behalf of Medicaid recipients, has put forth four "core issues" that must be considered integral to the evaluation process. 

1. Issues related to quality and quantity of "choice counselors" available to consumers: The first 22,000 mandatory enrollees were to be mailed notices of the choices of managed care plans beginning July 24. From that date, they were to have until Aug. 18 to choose one of 16 HMOs and PSNs in Broward to begin enrollment by Sept. 1. Choice counselors, contracted by AHCA and only recently trained and certified, are entrusted with helping beneficiaries make the right choice of plan. There are 10 field choice counselors in Broward and six in Duval County, in addition to 43 more working from a phone center in Tallahassee. The MRAC is very concerned that the ratio of choice counselors to beneficiaries is inadequate, and that they may lack the depth of information needed to give appropriate advice -- which can mean the difference between proper care and the endangerment of life. The recent GAO report giving low marks to a similar program intended to help Medicare Part D patients only heightens this concern. 

2. Outreach to hard to reach populations, i.e. the disabled and the homeless: Choice counseling, choice of plans and all the other potential benefits of reform are of little value if those who will be affected are not reached. Beneficiaries will have 30 days to make a choice or the state will make one for them. Among the issues to consider are those related to the availability of a trusted primary care physician in the new plan, rate of co-payments, breadth and scope of services available and accessibility (many Medicaid recipients have to rely on public transportation when they seek health care). A substantial percentage of Medicaid recipients are disabled and need -- or rather, are entitled by law to -- alternative means of communications such as large print, audio and closed-captioning. Many more are homeless and do not retrieve their mail from the agencies that provide them with that service on a regular basis. Still more are unable to comprehend the content of the notices they receive for reasons ranging from mental illness to a low level of education. MRAC is concerned that close attention is paid to the effectiveness of contracted marketing and outreach companies entrusted with reaching the Medicaid consumer market. 

3. Managed care caps and how they will affect services: Managed care companies, as businesses, are concerned with profit. For insurance companies, margins of profits are increased when the populations they cover are generally healthy and require little care. But in cases pertaining to HIV/AIDS and blood disorder patients -- both groups affected by reform -- costs of care quickly reach the hundreds of thousands of dollars. Health care for the most vulnerable should not be beholden to a bottom line. MRAC is concerned that coverage caps do not result in coverage gaps for those whose lives depend on consistent care. 

4. The re-establishment of the mandated Medical Care Advisory Committee: Years ago, the federal government mandated that AHCA install a Medical Care Advisory Committee, comprising a variety of stakeholders in health care to provide a sounding board on issues related to health care policy. Though mandated, the advisory committee has not met since 2000. A true "place at the table" for consumers and the advocates that protect their interest is essential in the evaluation of Medicaid reform. MRAC believes that the Medical Care Advisory Committee should be revived. Medicaid reform will ultimately succeed or fail on its own merits. But those who rely on Medicaid for their health care and survival should be afforded the opportunity to participate in the process. 

Andrew Leone is state organizer with Florida CHAIN (Community Health Action Information Network).
Copyright © 2006, South Florida Sun-Sentinel

Medicare Part D Beneficiaries Reaching the "Doughnut Hole" Pay for Drugs and Premiums

When it comes to new Medicare prescription drug plans, the good news from the federal government is that some 90 percent of seniors have enrolled.

The bad news is that an increasing number of beneficiaries are reaching their annual limit on prescription drugs and must pay out-of-pocket expenses before their plan’s coverage resumes.

It’s called the “doughnut hole:” Medicare beneficiaries typically pay a $250 deductible and then 25 percent of drug costs of up to $2,250 per year. After that, the beneficiary pays 100 percent of the cost of each prescription until out-of-pocket costs reach $3,600.

At that point, insurance resumes, and the beneficiary pays about 5 percent of the cost of each drug.

According to USA Today, a study by PricewaterhouseCoopers estimated that 3.4 million people would reach the “doughnut hole” this year. Some people chose to pay higher premiums to cover the gap -- about 2.4 million did so, according to the same study.

Some Congressional efforts are emerging to address this problem. Florida CHAIN will keep you updated as opportunities for advocacy develop.

For now, here are some possible ways to weather the gap:

• Seek generic drugs replacements to high-dollar medicine.
• Ask your physician or health care clinic for free samples.
• Call the state’s SHINE program (Serving Health Insurance Needs of the Elderly) at 1-800-963-5337 or click here for online assistance with prescription drugs or low-cost medications. 
• Click here to learn if prescription drug companies are offering assistance plans.   

HUNDREDS RALLY AT AVON PARK FOR FAIR IMMIGRATION

Access to Health Care at Risk

  July 27, 2006

Hundreds of supporters of immigrant rights gather in Avon Park Florida for a prayer vigil.

A steady drizzle and occasional lightning didn’t dampen the enthusiasm of several hundred people from all over the state as they joined a prayer vigil on July 23 to oppose the Avon Park Illegal Immigration Relief Act, a proposed city ordinance that takes a get-tough stance on illegal immigration. The main organizers of the event included Florida CHAIN’s partnering organizations Florida Immigrant Coalition and Farmworker Association of Florida.

council voted 3-to-2 last night against making English the city's official language. The proposed restrictions also included fines for those who offer jobs, services or housing to illegal immigrants. About 20 percent of Avon Park's nine-thousand residents are Hispanic. Avon Park is about 85 miles southeast of Tampa. (7/25/06, First Coast News) 

REAL STORIES

August 9, 2006

Thanks to John Reiss of Florida Institute for Family Involvement for bringing this aticle to Florida CHAIN's attention.

Christopher Rocha, 17, holds up his leg with the fractured ankle while his girlfriend, Sarah Dumich, 17, gets out cups for coffee at Rocha's home in Fort Pierce on Friday. Rocha fractured his ankle on July 4 and was taken to the St. Lucie Medical Center in Port St. Lucie, where he was released without surgery because the hospital didn't have a surgeon who took Florida KidCare, state insurance for minors. Rocha had to travel to Miami almost a month later, after finding a surgeon who accepted KidCare.

Florida CHAIN is also collaborating in a study by the Access Project that seeks to address the problem of under-insurance and inadequate insurance coverage. We are looking for individuals who have incurred medical or dental debt even though they have private insurance.  Having to resort to credit card use, retirement funds, or home equity to take care of medical costs qualifies for our purposes. The goal of this study is to challenge policy approaches that shift even more costs to consumers.The study will also try to identify policies and approaches that can help alleviate the problem of medical debt among people with insurance.If you or someone you know has such experience to share, contact Andrew Leone at andrewl@floridachain.org or 954/684-9895. 

 RECENT HEALTH ARTICLES

OP ED: MEDICAID REFORM  Major changes occurring with little attention
By Andrew Leone, State Organizer for Florida CHAIN
Medicaid reform, pursued by Gov. Jeb Bush and approved by the Florida Legislature in special session last December, is here amid no discernible fanfare and the apparent lack of interest on the part of the media. Touted as a way to control Medicaid spending while providing beneficiaries with a wider array of choices in services, reform entails moving users from Medicaid (the health care safety net of last resource for low-income Americans) to private managed care plans. In its first year, reform will affect over 130,000 Medicaid recipients in Broward County. By 2011, all 1.2 million Medicaid beneficiaries in Florida may be enrolled in managed care plans. Although the official start date for reform was July 1, media have taken no notice. In Broward, not even articles announcing the installment of Alan Levine (former secretary of the Agency for Health Care Administration) as the new CEO of the North Broward Hospital District mention his role as major architect of the reform plan.  (7/31/06, South Florida Sun-Sentinel)

OP ED Response: Vulnerable are being served

By Christa Calamas, secretary of the Florida Agency for Health Care Administration
(8/7/06, South Florida Sun-Sentinel)

Consumer Reports lists worst and best nursing homes in S. Florida
Florida fared better than many states in an analysis of nursing homes released Monday by Consumer Reports, with no homes on the list of the 12 worst in the nation. But three South Florida homes were among 17 in the state that investigators said families should avoid. Click here for online resources to check out Florida nursing homes. (8/8/06, South Florida Sun-Sentinel)

OPINION: Will 'pay first' solve or create emergency?

Two local hospitals have resorted to desperate measures to combat desperate emergency-room conditions. By forcing patients with non-emergencies to pay before being treated, St. Lucie Medical Center in Port St. Lucie and JFK Medical Center in Atlantis hope to relieve ER crowding. The risk is that the hospitals will endanger patients. (8/6/06, Palm Beach Post)

Medicare drug coverage gap leaves many seniors broke, or skipping medications
Seniors and disabled people with high prescription drug costs could soon find themselves in a hole -- the Medicare Part D doughnut hole. That's the point where millions of Part D participants -- currently paying only a small portion of their prescription drug costs -- will be required to foot their entire pharmacy bill until they spend a designated amount out of pocket. Includes Tips to help close Part D payment gap: For seniors and the disabled who are in the doughnut hole or teetering on its edge, here are some tips to help you with Medicare Part D's coverage gap, when you'll be asked to pay full price of your medications until your total out-of-pocket expenses have reached $3,600. (8/6/06, Miami Herald)

Fort Pierce family struggles through KidCare headaches
Christopher Rocha's family said he got the runaround for almost a month — not a good thing on a broken ankle.  Rocha, a 17-year-old St. Lucie West Centennial High School senior, had orthopedic surgery Wednesday in Miami, almost four weeks after limping into the emergency room at St. Lucie Medical Center in Port St. Lucie. The teen and his family said the long-delayed treatment caused them to question not only the hospital's policies but also Christopher's Medicaid health insurance through Florida's KidCare program. (8/5/06, Treasure Coast Newspapers)

Tallahassee Chamber of Commerce calls for no vote on health care tax
The Greater Tallahassee Chamber of Commerce issued a statement Saturday during its annual Community Conference, calling for the removal from the November ballot of the half percent sales tax for indigent health care. It echoed a similar resolution passed recently by the Tallahassee Memorial Healthcare Board of Directors. “We share a deep concern regarding the problem of uninsured individuals and families in our community. But real and significant unresolved issues have been raised about the county’s proposed plan and the mechanism to fund it,” the chamber’s resolution stated. (8/5/06, Tallahassee Democrat)

Florida County Taxes Itself for Near-Poor Health Care (Update2) 

Jeffrey Lockler had knots in his shoulder and groin, painful inconveniences in his work as a heating-system installer. The condition was life-threatening: testicular cancer. Lockler, who received his diagnosis in October 2003, had no private health insurance. Yet he is alive today, back on the job at his son's construction company in Tampa, Florida. He is also solvent, thanks to a tax collected by the county where he lives. Hillsborough County, which includes Tampa, is leading a local-government initiative to fill a wide hole in U.S. health care: the record 46 million Americans who lack medical insurance, according the federal Census Bureau. County residents pay a 7 percent sales tax on goods and services, a percentage point above Florida's minimum, largely to finance medical care for low-income residents who don't qualify for other U.S. plans. (8/4/06, Bloomberg)

Poll: Majority against increase in sales tax for Leon County uninsured
A new poll commissioned by critics of a sales-tax increase for the uninsured shows that more people are against the proposal than for it. Voters in the Nov. 7 general election will decide whether to increase the sales tax from 7.5 percent to 8 percent. The estimated $18 million in annual proceeds would provide primary health care for thousands of people who can't afford health insurance in Leon County.  Some people are questioning results of the poll. (8/2/06, Tallahassee Democrat)
 
OPINION: Medical Errors 
Medical board issues guidelines on medical mistakes.
Prevention is a prudent course, but the state Board of Medicine's wrist-slap approach to surgical errors might invite lawsuits and deepen mistrust. (8/3/06, South Florida Sun-Sentinel)

FSU speech and hearing clinic awarded $20,000; Civic group pledges future endowment totaling $500,000
Florida State University's L.L. Schendel Speech and Hearing Clinic received a $20,000 check Wednesday from the Scottish Rite Foundation of Florida. The money will be used to increase the number of area children with speech, language and hearing disorders who are diagnosed and treated. The foundation will raise money for a $500,000 endowment to support the clinic's work with children in Gadsden, Leon and Wakulla counties. With adoption of the FSU clinic, the Scottish Rite Foundation will be associated with 14 such clinics in Florida. (8/3/06, Tallahassee Democrat)

OPINION: Kids' dental care: Medicaid HMO Pilot with Disputed Results is Unacceptable
Results of the state's dental HMO experiment for children on Medicaid are in, but they don't show if the new approach is better than the old. That's unacceptable. The project was to improve access to dental care for 200,000 Miami-Dade children on Medicaid, reducing fraud and state costs in the process. The idea was to switch them to HMO coverage in 2004 and away from standard fee-for-service Medicaid. (8/3/06, Miami Herald)

Atlantic Dental to receive extension  
Despite sharply negative comments by critics -- including the Florida Dental Association -- state Medicaid officials plan to grant Atlantic Dental a two-year extension of its pilot project to provide services to Miami-Dade's poor kids.  (8/1/06, Miami Herald)

Study knocks Bush dental plan
The number of poor kids getting dental care plummeted 40 percent in the first year of a Medicaid pilot project in Miami-Dade, according to a study released this month by the University of Florida. (7/30/06, Miami Herald)

Medicare plan at 90% of sign-up goal  
A new study shows enrollment in Medicare Part D is lowest among healthy seniors, widows or unmarried women, and those who have lower incomes and less education.
A more recalcitrant cynic would have been hard to come by. A voracious student of Medicare Part D, Barbara Waks of Miami Beach had refused to enroll in the new government prescription drug plan until her children convinced her to give it a try. Eight months later, Waks is not thrilled. She's still concerned about costs and the possibility of her plan dropping her medicines, but this much she will say: ``It's been relatively good. It is saving me some money, not a big fortune, but nevertheless it's something.'' Efforts to reach every senior are ongoing. ''We have been putting out notices to people who are in the low income category,'' said Linda Merrell, healthcare consultant with several Florida nonprofits, including Florida Community Health Action Information Network. There is help for people who need it, but many just don't know how to get it, Merrell said.  (8/1/06, Miami Herald)

JFK hospital to divert walk-ins from emergency room to clinics
Emergency room patients without true emergencies will be asked to either pay their bills on the spot or go to an outpatient clinic, according to new rules taking effect today at JFK Medical Center. The Atlantis hospital's new policy is meant to reduce wait times and discourage people from using the emergency room for primary care.(8/1/06, South Florida Sun-Sentinel)

Lesson 10: Get a healthcare plan for employees
The health insurance system is sick. From 1993 to 2004 some 143,000 small employers in Florida -- half of all those insured -- dropped coverage entirely, according to a recent study. While price increases are making it harder to find affordable plans, there are still deals. (7/31/06, Miami Herald)

School shots jolt parents in the wallet
The number of required school vaccinations has risen to 12 for males and 13 for females and the cost has also risen -- to more than $1,000 per child. (7/31/06, Palm Beach Post)

The new force in walk-in clinics
Retail health clinics are spreading fast in supermarkets, drugstores and big-box chains across the country, luring patients with walk-in treatment for minor ailments like strep throat — at about half the cost of a typical doctor visit. The phenomenon has been largely driven by small start-up chains, which run the outlets under agreement with retailers and have had few formal ties to the medical establishment. Now, traditional medical providers are stepping up to the counter, driven by the threat of new competition, the opportunity to recruit new patients — and real concerns about the quality of care. Some large regional health-care systems are starting their own clinics directly with retail partners, while other medical groups and doctors offices are signing contracts to supervise clinic staff, and striking up referral arrangements with retail clinics. (7/30/06, Naples News)

OPINION: Cheaper, not imported  

Older Americans looking for cheaper prescription drugs could buy them - legally - from Canada, if a loophole the Senate approved last week also passes the House. But, as in years past, it's unlikely that Congress will overturn a Food and Drug Administration ban on importing prescription medicine - even only from trusted Canada, as the latest Senate proposal would allow. More reliable relief would come from Congress finally fixing Medicare Part D. The biggest problem with Part D is that lawmakers designed it three years ago as a program to benefit pharmaceutical companies, not as the prescription-drug insurance program seniors and disabled patients needed. Senators, who by a 68-32 vote last week supported importation of drugs from Canada, could be praised for trying to keep the option safe and accessible. The greater goal - and the way to make drug importation less desirable - is to make Part D better. (7/29/06, Palm Beach Post)

Preventing surgical mistakes
State licensing board opts for a system of checks over an increase in penalties.
The state medical licensing board has decided, after a year of study, against stricter discipline for surgeons who operate on the wrong body part or the wrong patient. Despite a continued climb in wrong-site surgeries, the physician-dominated Florida Board of Medicine said it will push doctors and hospitals to follow double-check systems that can prevent botched surgeries, rather than ratchet up the penalties for mistakes. (7/29/06, South Florida Sun-Sentinel)

OPINION: Congress Must Fix Medicare Formula
About this time every year, doctors who treat Medicare and military patients begin sounding alarms about looming cuts in their reimbursements because of a flawed funding formula. Federal lawmakers usually patch the problem in time to keep doctors from seeing their reimbursements drop, but the solution only lasts for a year. Congress, once and for all, needs to correct this reimbursement formula that left alone will lead to a severe shortage of doctors willing to see new Medicare patients. (7/28/06, Tampa Tribune)

Kids get dental care from 'Molar Express'
Medicaid patients have a place to go besides the ER
The Center for Dental Care & Prevention on Railroad Avenue isn't a typical dentist's office. Nicknamed "The Molar Express" because of its train-station theme, it treats patients between the ages of 5 and 20. The youngsters are on Medicaid, and without the facility, they'd have nowhere to go for dental care besides the emergency room. The dental center, the largest public-health dental facility in Florida, opened last year on Railroad Avenue next to the Amtrak Station. Although it serves some 4,000 young patients, the Health Department would have to open several more clinics of its size to meet the community need. That's because in 2004, some 25,000 children in Leon County were on Medicaid, said Dr. Ed Zapert, dental executive director. Local dentists don't accept Medicaid payments because reimbursements are low. (7/26/06, Tallahassee Democrat)

OPINION: Medicare crisis is approaching quickly
The immediate concern is Medicare. The first Baby Boomer will be eligible in just five years, with 78 million more to follow. Medicare, with costs well above $300 billion annually, already accounts for 3.3 percent of the nation's Gross Domestic Product. By 2030, it is expected to consume 7 percent and account for a third of the federal budget. Warnings of problems ahead are coming from organizations as diverse as the American Academy of Actuaries and the American Medical Association. What's needed is a complete overhaul, with everything on the table, including spending cutbacks, tax increases, a possible increase in age eligibility, and even health care rationing. ISSUE: It's time to take a thorough look at Medicare. (7/26/06, South Florida Sun-Sentinel)

Children in KidCare program climbs, but there are fewer than last year
The number of children getting health care coverage through the state has increased since January, but the numbers remain slightly lower compared to a year ago.  (7/26/06, WTSP-Tampa Bay's 10 News)

New Law Opens KidCare To More Families
Florida's KidCare insurance program is gearing up for a massive outreach effort when the school year starts. All 2.6 million elementary and high school students will get an application for the low-cost insurance program to bring home. Enrollment in the KidCare program is on the increase after a couple of years of decline. Working families, who made just a little too much money for their 1-to 4-year-olds to qualify for KidCare are getting some good news from the state. The new law, which went into effect this month, allows parents to sign up their children as long as they pay the full premium. (7/25/06, WESH News)

Survey: Affordable insurance available in parts of Florida, But it means paying a high deductible
Jacksonville ranked 34th among the nation's 100 largest cities for affordable health insurance for families, according to a survey of high-deductible health plans. Among other Florida cities in the study, St. Petersburg ranked 30th, Tampa was 35th and Miami came in at 55. Jacksonville turned out a more middle-of-the-pack performance in providing affordable health insurance for children - coming in at No. 57. St. Petersburg ranked 55th, Tampa was 60th and Miami came in at 69th. (7/25/06, Florida Times-Union)

Medicare reforms could snip reimbursement; Hospitals, patients would pay more for some surgeries
Medicare could take the scalpel to reimbursements for some highly profitable hospital services - a move that will inflict pain on both hospital and patient pocketbooks. The proposal, part of a major revision to Medicare's payment system, will cut reimbursement for some money-making surgical services like cardiac stent replacement and hip surgery. The change is likely to hit hardest specialized hospitals that focus on high-end surgical care. But even general hospitals, that offer a wider menu of services, could be affected. (7/23/06, Florida Times-Union)

Medicare Savings Programs offer help
For more than a year now, I have been pounding away about Medicare Part D and the extra help available for those with low income and assets, almost to the exclusion of anything else Medicare-related. Not that this has been an error on my part, you understand. But there are some other worthy programs that need attention, too.  Medicare Savings Programs may help pay for part of your Medicare expenses. If you qualify, you may get help with things such as Medicare premiums, deductibles or out-of-pocket expenses. (7/26/06, Palm Beach Post)

OP ED: Residents Should Be Catalyst For Improving Children's Health
By DR. PETER GORSKI
I wanted to address some troubling figures recently released by KidsCount, noted in your article entitled, "Advocates Say Kids Shortchanged," on June 28. As a pediatrician and father, I believe we can take action and realize more positive outcomes for Hillsborough County children by becoming aware and involved in our community.  Hillsborough County's infant mortality rate continues at around 9 per 1,000 live births. This is double that of communities, states and nations with the lowest rates. In fact, the number of low birth-weight babies born in our community has essentially gone unchanged over the past five years. (7/26/06, Tampa Tribune)

Drug Plans Need Accurate Information
The premise of Medicare's prescription drug program is that beneficiaries, after comparing the available plans, will choose the one that is best for them.  So it is infuriating that a study by the government's nonpartisan investigative arm found many seniors are being given incomplete or erroneous information about competing plans. This is disgraceful. (7/24/06, Tampa Tribune)

Jacksonville tops country in Medicare disparity in study of 24 cities
When it comes to picking drug plans - as with most other products - it pays to shop around. Jacksonville seniors had the highest variation in Medicare drug plan prices in a 24-city study conducted by a San Francisco-based nonprofit. Investigators suggest inadequate comparison-shopping by seniors helped fuel the disparity in drug plan prices. The analysis, by the Coalition to Advance Prescription Drug Education (CARxE), tracked the cost of seniors' 19 "most prescribed" drugs and bundles of drugs people might take for nine chronic conditions. The price of each plan includes premiums, deductibles and co-pays seniors would pay.  (7/13/06, Florida Times-Union)