[NYAPRS Enews] Advocates Assail NYS Proposals to Restrict Med Access

[Harvey Rosenthal]

NYAPRS Note: NYS advocates are weighing in to oppose proposals to limit
access restrictions re Medicaid mental health and other previously
excluded drug classes. In our budget testimony to both the Mental
Hygiene and Health/Medicaid committees, NYAPRS opposed the proposed
elimination of 'prescriber prevails' patient protections and the
inclusion of pharmacy into managed care. We also called for an expansion
of oversight mechanisms like PSYCKES that seek to limit the
overprescribing of medications (e.g. too many, too long). 

 

Medicaid Reforms Questioned At Hearing

By Cara Matthews  Gannett News Service  March 4, 2011

 

ALBANY -- A hearing Thursday on the state's health budget focused
largely on a panel's recent proposal to cut $2.3 billion from Medicaid,
with some speakers criticizing recommendations to limit
medical-malpractice awards and cut long-term and home care.

 

Patient advocates said Thursday that changes in the prescription-drug
program would restrict access to life-sustaining medicine for people
with lupus, HIV/AIDS, mental illness, kidney disease and other chronic
diseases....

 

Industry and patient-rights groups said some of the proposed changes
would have devastating impacts, and they asked lawmakers to change them.

 

For example, the report recommends authorizing the state Medicaid
director, not patients' physicians, to make final decisions regarding
prior authorization of non-preferred brand drugs over generics. It would
require prior authorization for currently protected classes of drugs --
anti-psychotics, anti-depressants, anti-retrovirals and
immunosuppressants. It would also move the Medicaid pharmacy benefit to
managed care.

 

"Disrupting continuity of care can result in detrimental,
life-threatening consequences to all individuals who are the most
vulnerable," said Kathleen Arntsen, president of the Lupus Foundation of
Mid and Northern New York in Utica. She has lupus.

Julie Mersereau, a lupus patient and board chairwoman of the Lupus
Foundation of Genesee Valley N.Y., said her medications are tailored to
her specific needs, and decisions about which ones she takes have to be
between her and her treatment team.

 

"To have an oversight or to have my doctor not be able to make the
determination about a particular drug is just impossible to even
consider," said Mersereau, of Penfield, Monroe County, who got the
disease 37 years go, when she was 14....

 

http://www.pressconnects.com/article/20110303/NEWS01/103030389/Proposed-
Medicaid-reforms-questioned-at-hearing?odyssey=tab|mostpopular|text|FRON
TPAGE 

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Poor, Infirm Say That Medicaid Cuts Will Hurt Them

Associated Press  March 4, 2011

 

ALBANY, N.Y. - Patients facing chronic diseases such as lupus, kidney
transplants, mental health disease and others living with HIV or AIDS
said Thursday that the state's cost-cutting will deprive them of needed
medications.

 

The groups are trying to get the Legislature to reject two of the dozens
of measures recommended by Gov. Andrew Cuomo's Medicaid reform task
force, the group working to reduce costs of the massive system. At the
heart of the proposed reform is directing almost all patients to managed
care, a kind of HMO model in which patients have regular contact with
physicians and the most efficient methods of care are used.

 

Cuomo spokesman John Milgrim said the reforms won't deny any patient
necessary medications under a more efficient managed care model, like
private HMOs, and would direct the use of generic drugs only when
feasible and equally effective.

 

But the patients and their advocates said the measures will limit their
doctors from prescribing the array of medications they need, forcing
them to follow more stringent direction on treatments rather than an
often unique medication regimen. The patients also say the changes would
force the use of generic drugs that don't always work as well.

 

"Disrupting continuity of care can result in detrimental,
life-threatening consequences to the individuals who are the most
vulnerable and can actually lead to more medical complications and
higher health care costs," said Kathleen Arntsen, president and patient
advocate for the Lupus Foundation of Mid and Northern New York. "Nothing
should come between a patient and his or her physician; this
relationship is crucial in attaining the most optimum medical care."

 

Kathe LeBeau, who is awaiting a kidney transplant, said certain drugs
would be restricted under the reform proposal that are crucial for
kidney patients to get a transplant.

 

The measures would save $140 million and promote managed care, a
comprehensive method of treatment than many Medicaid recipients receive
now when they seek out new doctors when different problems arise.

 

"Nobody will be denied necessary medications," Milgrim said. He said the
Medicaid Redesign Team staff welcomes the advocates to express their
concerns as the proposals are considered by the Legislature before they
are included in the budget, due April 1.

 

http://online.wsj.com/article/AP005d3d14a6ed440eaf21e8ad5d45958d.html 

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