Public Employee Press

MLC pact protects PICA drugs

By GREGORY N. HEIRES

The city and municipal unions have reached an agreement to continue covering 500,000 public employees and retirees for four categories of expensive and often life-saving drugs.

Under the deal, both parties will restructure the PICA program, which provides psychotropic, injectable, chemotherapy and asthma drugs, and the city will beef up its payments to union benefit funds to ensure that employees and retirees continue to receive the drugs.

Beginning July 1, chemotherapy and injectable drugs will be covered by the GHI health plan or the Stabilization Fund, which was set up years ago to equalize funding of the city’s health-care plans and has funded the PICA program. Psycho-tropic and asthma medications will be provided by union welfare funds, such as the DC 37 Health and Security Plan, or elsewhere through optional health-plan riders.

Mayor Michael R. Bloomberg announced the changes April 4 at a joint news conference with the Municipal Labor Committee, the umbrella organization that represents city unions in negotiations over health-related benefits.

“We have crafted a short-term solution that saves these life-sustaining benefits,” said MLC Chair Randi Weingarten.

In labor’s efforts to identify resources to save the PICA coverage, DC 37 Executive Director Lillian Roberts, MLC’s secretary, and Steering Committee members Veronica Montgomery-Costa, Maf Misbah Uddin and Charles Ensley played an important role, with other municipal labor leaders.

For injectable and chemotherapy drugs, on July 1 retail co-payments will be raised to $10 (from $5) for 30-day supplies of generic drugs, $25 (from $15) for brand-name medication on a preferred list and $45 (from $35) for non-preferred brand-name drugs. Mail-order co-payments for 90-day supplies will be double the amount of 30-day retail co-payments. Beginning Jan. 1, 2006, there will be an annual deductible of $100 per person.

The co-pays of the DC 37 prescription drug benefit ($5 for generics, $15 for brand-name preferred drugs and $35 for non-preferred drugs) will remain for asthma and psychotropic drugs. The plan’s trustees will study whether changes will be necessary to address any additional costs, according to Rosa Esperon, administrator of the DC 37 Health and Security Plan.

City coverage of injectable and chemotherapy drugs will continue to be funded through the health-care Stabilization Fund.

Last year, the city told the unions PICA costs had risen to $140 million a year and were draining the fund. The city threatened to shut down the PICA program in January, but it backed off that threat after the MLC insisted upon negotiations.

Under a 2004 agreement, union welfare funds are receiving an extra $65 per member, which will be suspended from July 1, 2005, to Jan. 1, 2006, to help shore up the Stabilization Fund. To help the union funds with the burden of the asthma and psychotropic coverage, the city agreed to contribute an additional $100 for each employee and retiree from July 1, 2005, through June 30, 2006.