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The National Health Policy Forum convened a meeting on July 22, 2004 to discuss state-based challenges associated with implementing the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The meeting brought together an extremely insightful and experienced group of current and former state officials and other experts to discuss key issues. In keeping with its tradition of promoting a frank, off-the-record exchange on health policy issues, NHPF does not normally prepare written summaries or reports of meetings. However, because this meeting provided vivid illustrations of the importance of state-federal collaboration for the successful implementation of the new Medicare drug benefit, participants agreed that the information should be shared more widely. Thus, this report is intended to provide a candid montage of the July 22 meeting and supply additional information and insights into state issues surrounding MMA implementation. Though the MMA offers a huge number and range of potential subjects, the discussion was focused around four primary areas affecting states: eligibility, enrollment, and outreach; the transition for dual eligibles; financing challenges; and administrative and systems issues.

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