This report is a case study of five states’ (California, Georgia, Oklahoma, Oregon, and Washington) implementation of prior authorization in their Medicaid programs.
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.
Featured Prescription Drugs Resources
KFF Health Tracking Poll – October 2019: Health Care In The Democratic Debates, Congress, And The Courts
This poll examines health care issues in the Democratic presidential primary , government negotiation of prescription drug prices, party trust on health care, Medicare-for-all, and the pending Texas v. US lawsuit affecting the Affordable Care Act and pre-existing condition protections.
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Related Prescription Drugs Resources
- Management and Delivery of the Medicaid Pharmacy Benefit
- Understanding the Medicaid Prescription Drug Rebate Program
- A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries
- Kaiser Health News Coverage of Prescription Drug Issues
- What are the recent and forecasted trends in prescription drug spending?
- What’s the Latest on Medicare Drug Price Negotiations?
- How Will The Medicare Part D Benefit Change Under Current Law and Leading Proposals?
- Medicaid’s Prescription Drug Benefit: Key Facts
- Public Opinion on Prescription Drugs and Their Prices
- Prescription Drug Rebates, Explained
- What Are Recent Trends and Characteristics of Workers with High Drug Spending?
- Snapshots of Recent State Initiatives in Medicaid Prescription Drug Cost Control
- 10 Essential Facts About Medicare and Prescription Drug Spending
- Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs
- How Does Prescription Drug Spending and Use Compare Across Large Employer Plans, Medicare Part D, and Medicaid?
This quick primer explains the similarities and differences among major Medicare prescription drug proposals introduced by House Democrats, the Senate Finance Committee, and the Trump Administration. Updated October 2019.
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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
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
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 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
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…
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…
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
An updated fact sheet summarizing the latest statistics and trends regarding the role of Medicaid in providing prescription drug coverage.Fact Sheet
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…