Government Relations

UM Legislative Update Newsletter

October 28, 2005

Medicaid Reform Commission hears testimony at final meeting

The Medicaid Reform Commission met Wednesday, Oct. 12 and Thursday, Oct. 13 to hear testimony on mental health and pharmacy issues. These hearings were the last of the formal meetings scheduled on specific subjects. The commission now plans to hold four days of work sessions for the purpose of developing a final report with recommendations to the governor and the General Assembly.

The commission heard testimony on mental health from managed care representatives, providers and the director of the Missouri Department of Mental Health. While some testified to the cost-effectiveness of a managed care delivery system, others cautioned against taking care away from current providers who are familiar with the patients and Missouri’s system.

Providers also recommended increasing local care management of certain diseases; including the most current psychotropic drugs in the formulary; allowing patients to work and receive Medicaid; limiting the use of the exception process as a utilization control; and creating incentives for patients to work and live in the least restrictive environment.

Pharmaceutical representatives praised several current programs within the Department of Health and Senior Services, such as E-Prescribe and the Disease State Management Program. In some cases, expansion of the programs was recommended. The commission then heard testimony outlining the current process for distributing and financing prescription drugs for Medicaid patients.

Also discussed were prospects for federal action affecting state Medicaid programs, including relief from the federal “clawback” law. This law requires states to make payments to the federal government to offset the cost of transferring to Medicare from Medicaid the responsibility to provide prescription drug coverage for those eligible for both programs.

Work sessions will be held Oct. 26-27 and Nov. 9-10 at the State Capitol in Jefferson City.

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