National Alliance on Mental Illness
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March 12, 2003

NAMI Issues Statement on Medicaid Malpractice

NAMI today issued a statement and press release entitled "Medicaid Malpractice - States Put Patient Recovery At Risk By Restricting Prescription Drugs". The statement expresses strong concerns about policies either being instituted or considered in 45 states to restrict access to psychiatric medications in state Medicaid programs. The statement also describes NAMI's 10 point policy for federal and state action for federal and state action to prevent these "penny wise but pound foolish" restrictions.

"These ten points call for Federal and state action," said Michael Fitzpatrick, director of NAMI's Policy Research Institute (NPRI). "In too many cases, current state initiatives to control drug costs are penny wise, but pound foolish. Too many times in the past, people with mental illnesses have been neglected or abandoned at a terrible cost. As a society, we know how to treat mental illnesses, but too often, the investment is too little, too late."

"Restrictions on access to effective medication are acts of budget desperation— not enlightened leadership. They will compromise recovery and lead to greater costs elsewhere. They represent bad medicine and Medicaid malpractice."

States are not putting the interests of patients first.

Approximately 45 states are instituting or considering restrictions on Medicaid drug benefits—through preferred drug lists, fail-first requirements, pill- splitting, increased co-payments and other measures. The cost of prescription drugs has increased an average of 18 percent since 2000, and is considered the most significant factor responsible for increased Medicaid costs.

The NAMI program includes support for the National Governors Association in seeking to increase the Federal Medical Assistance Percentage (FMAP) for Medicaid.

Debate over drug restrictions has been especially fierce this year in Colorado, Florida, Georgia, Illinois, Iowa, Massachusetts, Mississippi, Nevada, New Jersey, New York, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, Texas, Tennessee, Washington, West Virginia, Vermont, and Virginia.

"The debate will extend well beyond 2003," Fitzpatrick said. "Anyone who thinks this year is bad should wait until 2004. Legislatures are undermining doctor- patient relationships and the exercise of professional judgment."

View the text of 10-Point Program