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

    Issue Brief

    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 Medicaid -- a cap on federal Medicaid funding for all services provided to seniors on Medicaid. Policy Brief

  • Medicare and Prescription Drugs, Fact Sheet

    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)

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

    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 on a number of cost management strategies to constrain the growth in drug spending including formularies, tiered-copayments, mail-order benefits, and fixed caps or dollar limits…

  • The Development of Direct-to-Consumer Prescription Drug Advertising Regulation

    Other Post

    This article, which appears in the Food and Drug Law Journal, vol. 57, no. 3, 2002, pp. 423-444 was based on a report written by F.B. Palumbo and C.D. Mullins at the University of Maryland School of Pharmacy Center on Drugs and Public Policy and funded by the Kaiser Family Foundation. The article provides an historical overview and current U.S. Food and Drug Administration regulation of advertising prescription drugs directly to consumers. The article also…

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

    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 information on the series see the National ADAP Monitoring Project page. Issue Brief

  • New Reports Explore State Implementation of Prescription Drug Prior Authorization

    Other Post

    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…

  • Case Study:  Michigan’s Medicaid Prescription Drug Benefit

    Report

    Case Study: Michigan's Medicaid Prescription Drug Benefit This 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 any drug not included on the MPPL. Background Paper  

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

    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 36% of all Fortune 100 companies and 28% of all Fortune 500 companies. Information was collected on a variety of topics including costs, premiums, retiree…