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Medicaid Reform Commission Endorses Higher Co-Payments for Prescription Drugs, Medication Access Restrictions, Rejects Bid to Narrow Definition of Rehabilitation and Case Management Services

August 22,2005

On August 18, 2005, a federal Commission charged with developing changes to the Medicaid program endorsed a series of recommendations to Congress for trimming future spending by $10 billion over the next 5 years. These changes included a number of recommendations that would have an enormous impact on beneficiaries with severe mental illness including higher co-payments for prescription drugs and diminished access to specific medications through prior authorization, therapeutic substitution and other administrative barriers.

This Commission – authorized by Congress and selected by HHS Secretary Mike Leavitt – will now shift to developing long-term reforms for Medicaid by late 2006. In the meantime, Congress will be finalizing legislation cutting Medicaid by $10 billion over the next five years in September. While the recommendations of this Commission are not binding on Congress, they will carry significant weight. Likewise, a separate set of proposals from the Bush Administration will also be considered by both the House Energy & Commerce and Senate Finance Committees early next month.

Action Required

Advocates are strongly encouraged to forward the a letter to members of Congress urging them to:

*oppose increases in co-payments for prescription drugs covered under Medicaid,

*oppose restrictions to the definition of rehabilitation and case management services recommended by the Bush Administration, and

*oppose efforts to restrict access to medications to treat mental illness through increases in supplemental rebates.

Enter your zip code below to access a sample letter on this issue and a list of your representatives to contact now.  If you do not see the box for entering your zip code, click here.

NAMI Testimony to HHS Medicaid Commission

At an August 18 hearing, NAMI offered testimony to the HHS Medicaid Reform Commission, outlining concerns about higher beneficiary co-payments, rehabilitation and case management services, restricted access to medications, the IMD exclusion and other issues. Click here to view the NAMI testimony (PDF).

Click here to view background information on actions taken by the HHS Medicaid Commission on August 18 and current Medicaid issues now before Congress.

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