DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland 21244-1850 
Center for Medicaid and State Operations 
SMDL #06-024 
 
Dear State Medicaid Director, 
 
I am writing to request your assistance in ensuring a smooth end-of-year transition for the 
low-income beneficiaries we both serve.  State Medicaid Agencies were important 
partners during the Initial Enrollment Period for the Medicare Part D prescription drug 
benefit, and we are committed to continuing to work together closely as we approach the 
Medicare Annual Coordinated Election Period (AEP) that begins November 15, 2006.   
 
We believe the key to a successful transition is to have beneficiaries who need to change 
plans do so as early as possible in the AEP.  Thus, we are emphasizing in all our outreach 
materials that individuals who intend to join or change a Medicare prescription drug plan 
should do so by December 8, 2006, if at all possible.  Doing so will ensure time for the 
necessary data exchanges to be completed and notifications provided so that individuals 
will have their correct plan ID cards in hand and all parties  The Centers for Medicare & 
Medicaid Services (CMS) and its contractors, beneficiaries, pharmacists, Part D plans, 
and States  have the correct plan enrollment information in place on January 1, 2007.   
 
As you know, CMS has already taken action to re-assign all individuals who are again 
eligible for a low-income subsidy in 2007, but who could face a Part D premium in their 
current plan.  We are confident that, absent further plan changes, these individuals will be 
successfully enrolled in their new plans by January 1, 2007, with appropriate plan 
enrollment and subsidy information in place.  However, we know that many states have 
the authority to act as authorized representatives for purposes of enrolling Medicaid 
beneficiaries into Part D plans.  So, we urge you to let us know as soon as possible if 
you intend to re-assign beneficiaries already in enrolled in a Part D plan to a 
different Part D plan effective in 2007.   We want to make sure that any such State 
efforts are carried out in a timely manner and are carefully coordinated with our recent 
re-assignment process, and our overall efforts for an effective end-of-year transition.   
 
If you intend to re-assign any Medicare beneficiaries, please contact Mike Fiore as soon 
as possible.   He can be reached at Michael.Fiore@CMS.hhs.gov or 410-786-0623.  
 
Again, we appreciate your continued assistance in ensuring the most vulnerable Medicare 
beneficiaries have effective prescription drug coverage. 
  Page 2  State Medicaid Director 
 
Sincerely, 
 
Dennis G. Smith 
Director           
 
cc: 
CMS Regional Administrators 
 
CMS Associate Regional Administrators for Medicaid and State Operations 
 
Martha Roherty 
Director, Health Policy Unit 
American Public Health Services Association 
 
Joy Wilson 
Director, Health Committee 
National Conference of State Legislatures 
 
Matt Salo 
Director of Health Legislation 
National Governors Association 
 
Lynne Flynn 
Director for Health Policy 
Council of State Governments 
 
Christine Raniszewski Herrera 
Director, Health and Human Services Task Force 
American Legislative Exchange Council 
 
Jacalyn Bryan Carden 
Director of Policy and Programs 
Association of State and Territorial Health Officials