If you live in Utah and your meds are covered by Medicaid - you should be
aware of these proposed changes in prescription coverage ... as should
everyone -- other cost-cutting actions could happen elsewhere as many
states are strapped for money.
Note the article says,
" Medicaid announced the changes, which take effect Jan. 1, in a Dec. 14
letter
to clients. Excluded from the limitations are pregnant women and children
under
21. Also exempted are medicines for illnesses such as AIDS, cancer and
diabetes,
along with some high blood pressure, high cholesterol and heart
medications."

--It is nice that the Utah Health Department provided exemptions for at
least some serious illnesses, but you have to wonder if they understand
the needs for Parkinson's medications at all?

Linda Herman
P.S. On a less serious note --  If anyone, especially those  in warm
climates,  would like some  snow ( just think - you could be the only one
on your block with a snowman in your yard) -- please just call anyone in
Buffalo N.Y. We are running out of places to put it!

ARTICLE FROM:
 The Salt Lake Tribune
 December 28, 2001, Friday
SECTION: Final; Pg. D2

HEADLINE: Medicaid Prescription-Limit Plan Under Fire; Advocates consider
legal
action on behalf of elderly, disabled

BYLINE: ASHLEY E. BROUGHTON, THE SALT LAKE TRIBUNE

"Advocates for the elderly and disabled said Thursday they are
considering
legal action after a proposed cost-cutting measure that would limit
Medicaid
recipients to seven prescriptions per month.

   "This particular policy will kill people," said Barbara Nelson, an
independent physician who practices geriatric medicine in several Salt
Lake
City-area nursing homes. "We're talking very frail people here."

   The state Department of Health, which oversees Utah's Medicaid
program, says
it had no choice but to impose the limits, given a $ 200 million state
budget
shortfall. The only other option would have been to eliminate another
service.

   "We realize that there are a lot of people that require more than
seven
prescriptions," said spokesman Steve McDonald. Hopefully, the limits will
be
temporary, he said.

   Medicaid announced the changes, which take effect Jan. 1, in a Dec. 14
letter
to clients. Excluded from the limitations are pregnant women and children
under
21. Also exempted are medicines for illnesses such as AIDS, cancer and
diabetes,
along with some high blood pressure, high cholesterol and heart
medications.

   Nelson said her average patient takes more than 12 medicines; some
have more
than 20.

   That includes over-the-counter pain relievers or vitamins, which were
also
covered by Medicaid. "Those are things that we just can't say, 'Well, you
can't
have it.' "

   Also, advocates are concerned about mental health medications. "You
may be
taking four or five medications for a psychiatric disorder, and God
forbid, you
get an ear infection," said Fraser Nelson, executive director of the
Disability
Law Center.

   "We're pretty irate . . .  it's just horrifically handled. We've been
getting
phone calls from a lot of people with disabilities, people in nursing
homes,
nursing home staff."

   The staff is preparing in case formal legal action is needed, said Rob
Denton, senior attorney for the law center. "We've tried to let the
Department
of Health know we're getting all these calls and a lot of pressure."

   Medicaid is a federal low-income program that uses state matching
funds. To
qualify, recipients usually need to meet income requirements and be older
than
65, blind, permanently disabled or have a child under 18.

   A statement sent out by Medicaid said the cuts were discussed at the
Medical
Care Advisory Committee's monthly meeting Dec. 20.

   But Ted Loosli, vice chairman of that committee and board chairman of
the
Disability Rights Action Committee, said the medication limits weren't
mentioned. "They talked about the budget and asked for some ideas," he
said. The
committee is planning a protest for tomorrow.

   "[The medications] are allowing people to work and stay productive,"
Loosli
said. "They'll end up back in the hospital. It's just going to end up
costing
more money."

   Those with more than seven prescriptions, after checking for
exemptions,
should "contact their doctors to see if all prescriptions are indeed
required,"
according to a Medicaid statement.

   "Who's going to make that decision?" asked Barbara Nelson. "What's
more
important? The Parkinson's medication? The blood pressure medication?"

   The Medicaid statement also urges clients to look to family members or
church
organizations for help. A plan called "The Medicine Program" will work
with
medical providers to provide free medication for a low processing fee, it
says.

   Still unknown, critics say, is how the agency plans to enforce the
limit and
if Medicaid will still cover additions like flu shots, among other
questions.

   Nelson said she anticipates having to send patients at the
seven-prescription
limit to the hospital instead of treating ailments like pneumonia or
urinary
tract infections in the nursing home.

   And some patients, denied their psychotropic medication --
anti-anxiety or
anti-psychotic medicine -- will become aggressive and violent, she said.

   "Then what do you do?" she asked. "Whoever thought of this did not
think very
long-range. They've opened a huge can of worms in this state."




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