Model Prescription Drug Prior Authorization Process for State Medicaid Programs April 1, 2003 Report 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
Prior Authorization for Medicaid Prescription Drugs in Five States: Lessons for Policy Makers April 1, 2003 Report This report is a case study of five states’ (California, Georgia, Oklahoma, Oregon, and Washington) implementation of prior authorization in their Medicaid programs.
How Do M+C Plans Manage Pharmacy Benefits? Implications for Medicare Reform March 31, 2003 Report 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…
Issue Brief: Trends in Opportunistic Infection Drug Coverage and Spending by AIDS Drug Assistance Programs January 31, 2003 Issue Brief 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…
Case Study: Michigan’s Medicaid Prescription Drug Benefit December 31, 2002 Report 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…
The Current State of Retiree Health Benefits: Findings from the Kaiser/Hewitt 2002 Retiree Health Survey November 29, 2002 Report 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…
Kaiser Health Poll Report – October 2002 October 31, 2002 Poll Finding A broad and informative bimonthly report, the new Kaiser Health Poll Report provides key tracking information, including historical trends and in-depth analysis of public opinion about hot health care topics. The current Featured Topic contains additional trends in public knowledge and attention to news about seniors and prescription drugs, as…
Medicaid and Prescription Drugs October 30, 2002 Fact Sheet An updated fact sheet summarizing the latest statistics and trends regarding the role of Medicaid in providing prescription drug coverage.Fact Sheet
Medicaid and the Prescription Drug Benefit October 30, 2002 Issue Brief This policy brief includes background information on Medicaid and its drug benefit, provides examples of how states are using the cost containment mechanisms at their disposal and addresses issues surrounding beneficiary access to outpatient drugs.Policy Brief
Medicare’s Disabled Beneficiaries: The Forgotten Population in the Debate Over Drug Benefits August 31, 2002 Report About 5 million Americans under age 65 qualify for Medicare coverage because they are totally and permanently disabled. They are more likely than the elderly to live in poverty, to be in poor health, and to experience difficulties living independently and performing basic daily tasks. A new study from The…