New Reports Explore State Implementation of Prescription Drug Prior Authorization

States are grappling with a fiscal crisis that threatens funding for Medicaid, the federal-state partnership that provides health coverage for low-income populations. Two new studies shed light on the impact of an increasingly popular strategy – prior authorization – being used to control prescription drug spending. In fiscal year 2003, some 21 states are planning to expand or create prior authorization systems where the state must provide pre-approval before selected drugs can be dispensed to Medicaid enrollees.

• Prior Authorization for Medicaid Prescription Drugs in Five States: Lessons for Policy Makers
• Model Prescription Drug Prior Authorization Process for State Medicaid Programs