The Administration is touting new $250 checks for seniors who hit the Medicare Part D coverage gap. But the State of Vermont is arguing that if the money is to defray drug costs, and not just a political giveaway, then they should be receiving those checks for the seniors who get their drugs paid for by the state Medicaid program. “The dust-up over rebate checks and who should receive them underscores the challenges of the federal-state partnership in health reform’s implementation. While rules and regulations are written within the Beltway, most of the heavy-lifting, in terms of implementation, rests with state governments.”