Center for Medicare Advocacy Summarizes State Medicaid Programs that covering Part D gaps for dual-eligibles

From the Center for Medicare Advocacy:

The Medicare Modernization Act  (MMA) excludes certain drugs from coverage under Medicare Part D, the new  prescription drug program.  The excluded drugs include barbiturates  (often used for seizure disorders or to relieve anxiety); benzodiazepines  (including Xanax and Valium, and other drugs often used for anxiety and  insomnia); drugs used for anorexia, weight loss, or weight gain; fertility drugs;  drugs used for cosmetic purposes or hair growth; cough and cold medicines;  prescription vitamins and mineral products; and over-the-counter drugs.

The drugs excluded under Part D  are drugs that states are not required to cover under their Medicaid programs;  states have the option of covering these drugs now.  The Centers for  Medicare & Medicaid Services (CMS) has indicated that states have the  option to continue paying for excluded drugs under their Medicaid program for  people who are dually eligible for Medicare and Medicaid (dual  eligibles).  CMS has cautioned states that if they cover some or all of  these drugs for one category of Medicaid beneficiaries, they must cover them  for all Medicaid beneficiaries.  In other words, states cannot cover  some or all of these drugs for all Medicaid recipients except for the dual  eligibles.

CMS has  included information on its web list of the excluded drugs covered by  Medicaid for each state, http://www.cms.hhs.gov/medicarereform/states/optdrugcov.asp.  A summary of that information is included at the end of this Alert.

Get the summary here. You can also sign up to receive the CMS’s weekly newsletter here.