Concerns Raised About Limiting Rx Drug Access for Medicaid Enrollees

States' efforts to reduce Medicaid spending by limiting the number of prescription drugs the program will cover has been criticized by some health care providers, who say the move could harm patients, Kaiser Health News/USA Today reports.

According to the Kaiser Family Foundation, 16 states -- including California and Texas -- have enforced a limit on the number of medications that Medicaid beneficiaries can obtain each month, while seven states have either implemented similar caps or strengthened them over the past two years.

The monthly restrictions vary by state. For example, Mississippi has a cap of two-brand name drugs per month while Arkansas allows six, KHN/USA Today reports.

Physicians in Illinois -- which became the latest state to impose a four-drug-per-month limit -- say they understand the need for reduced Medicaid spending.

However, William Werner, president of the Illinois State Medical Society, said, "[O]ur concern is it not be a hardship for patients and a hassle for doctors in the execution."

Meanwhile, providers in Alabama -- which had one of the nation's strictest Medicaid drug-benefit policies, at one brand-name drug per month -- are welcoming the state's recent decision to relax the limit to four brand-name drugs, according to KHN/USA Today. The current policy generated larger than anticipated savings.

Jarod Speer, a family doctor in Alabama, said that while most of his patients can use generic drugs, some with more serious issues like asthma and other lung diseases faced limited options without access to brand-name alternatives (Galewitz, Kaiser Health News/USA Today, 7/24).