Amid heightened public concern, the cost of prescription drugs is the focus of renewed attention by the Trump administration and lawmakers in Congress and state capitals. Proposed actions range from sweeping health care system changes to targeted initiatives that could affect Medicare, Medicaid and private insurance. See KFF’s research, analysis and public opinion data, as well as Kaiser Health News’ journalism, related to prescription drugs and their costs.

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The Henry J. Kaiser Family Foundation

Pharmacy Plus Waivers: Trade Offs Between Expanding Rx Coverage and Global Caps in Medicaid

The Kaiser Commission on Medicaid and the Uninsured has been monitoring the development of the Pharmacy Plus waiver initiated by the Bush Administration in 2002 and tracking the states that have pending or approved plans. The Commission has developed some materials describing the initiative, examining the financing mechanism, and discussing…

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The Henry J. Kaiser Family Foundation

The Financing of Pharmacy Plus Waivers: Implications for Seniors on Medicaid of Global Funding Caps

This policy brief describes Pharmacy Plus waivers being considered by some states for their Medicaid program and their implications for Medicaid financing. These waivers offer an opportunity for prescription drug coverage for low-income seniors, but they also include a major change in the financing of care for all seniors on…

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The Henry J. Kaiser Family Foundation

National ADAP Monitoring Project, Annual Report, April 2003

This report, the seventh in an annual series, provides an overview of the status of state-administered AIDS Drug Assistance Programs (ADAPs) and documents how these programs are responding to the changing fiscal, clinical and epidemiological dynamics of HIV/AIDS.ADAPs, authorized under Title II of the Ryan White Comprehensive AIDS Resources Emergency…

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The Henry J. Kaiser Family Foundation

Medicare and Prescription Drugs, Fact Sheet

This fact sheet, updated in April 2003, profiles current sources of prescription drug coverage among the Medicare population, describes the characteristics of beneficiaries who lack drug coverage and the implications of being without such coverage, and provides current data on prescription drug use and spending. Fact Sheet (.pdf)

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The Henry J. Kaiser Family Foundation

Prior Authorization for Medicaid Prescription Drugs in Five States: Lessons for Policy Makers

This report is a case study of five states’ (California, Georgia, Oklahoma, Oregon, and Washington) implementation of prior authorization in their Medicaid programs.

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The Henry J. Kaiser Family Foundation

Model Prescription Drug Prior Authorization Process for State Medicaid Programs

This report details the rules governing prior authorization programs and the major steps in a model process based on key issues raised by beneficiary advocates, provider groups and states.Report

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The Henry J. Kaiser Family Foundation

How Do M+C Plans Manage Pharmacy Benefits? Implications for Medicare Reform

Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years. Findings show that plans rely…

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The Henry J. Kaiser Family Foundation

Issue Brief: Trends in Opportunistic Infection Drug Coverage and Spending by AIDS Drug Assistance Programs

This issue brief, prepared as part of the National ADAP Monitoring Project, examines ADAP formulary coverage of medications for the prevention and treatment of AIDS-related Opportunistic Infections across states, including trends in coverage and expenditures over time, and discusses some of the potential reasons for variations in coverage. For more…

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The Henry J. Kaiser Family Foundation

Case Study:  Michigan’s Medicaid Prescription Drug Benefit

Case Study: Michigan's Medicaid Prescription Drug BenefitThis report describes the legislative process behind and content of Michigan's Pharmaceutical Product List (MPPL), a selection of preferred drugs available to be prescribed in the Medicaid program with little restriction. Providers would be required to obtain prior authorization from the state to prescribe…

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The Henry J. Kaiser Family Foundation

The Current State of Retiree Health Benefits: Findings from the Kaiser/Hewitt 2002 Retiree Health Survey

This report presents findings from a study of large private-sector employers conducted by researchers at Hewitt Associates and the Kaiser Family Foundation between July and September of 2002. The study is based on survey responses of 435 large private-sector firms (1,000+ employees) that currently offer retiree health benefits, and includes…

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