POTENTIAL RESTRICTIONS IN ACCESS TO MEDICATIONS

Pharmaceutical Benefits Under State Medical Assistance Programs

This is a very extensive state-by-state review of State Medicaid programs' pharmaceutical benefits, done in 2007 by the National Pharmaceutical Council. 

DEA reverses its rules regarding multiple prescriptions for Schedule II controlled meds

Since September 2006, medications that are classified as schedule II controlled substances, such as stimulants (which are commonly prescribed for attention deficit disorder) had required new prescriptions every month.  This was challenging for patients, families and prescribers. The DEA has reversed its policy on this effective Dec 1, 2007, such that subsequent prescriptions can be written covering up to 90 days of medication. 

Information relative to Iowa Medicaid Preferred Drug List Information

Like many states, Iowa will be instituting a Preferred Drug List (PDL) for its Medicaid program in an effort to curtail ever-increasing costs medications.  The legislation which enabled this specifically excludes psychiatric medications, at least for now, but this may change in the future. Stakeholders in Iowa's mental health community should be following this unfolding story closely.

See the Iowa Medicaid PDL webpage for details

Presentation on status of PDL

This is a "primer" which introduces some of the basic terms and issues regarding restricted formularies, preferred drug lists, etc., specifically as it relates to Iowa's public mental health system.  (Powerpoint presented by Dr. Flaum at the Iowa Mental Health Conference, October 11, 2004)

Information relative to Medicare Legislation and Rules

Mental Health Information on Medicare Part D

A useful site sponsored by a variety of mental health advocacy groups - lots of information for providers, consumers and families.

Study finds large discrepancy between Medicare Part D and private insurance

A recent NIMH-sponored study by the Medstat group finds substantially larger out of pocket medication expenses for elders with mental illness through Medicare Part D than through private insurance.

Updated information on Medicare Part D Drug Benefit

From the University of Iowa Center on Aging, a good general resource that is kept up to date.

Issue paper on Medicare changes for dual eligibles

Good review of the issues

Lack of coverage for benzodiazepines under Medicare for dual eligibles

This is one important category of medications that will not be available to dual eligibles as of November '06. This will impact many patients with serious mental illness.