Part D Utilization Management Barriers for Persons with Serious Mental Illness
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SubjectsMedicaid Part D prescription drug benefits
persons with both Medicare and Medicaid coverage (duals)
duals with serious mental illness (SMI)
Medicare Part D utilization management (UM) strategies
Hilltop staff made several presentations at the 2015 AcademyHealth Annual Research Meeting (ARM) held June 13 through June 15 in Minneapolis. Senior Research Analyst Michael T. Abrams, MPH, presented this poster at an ARM poster session on June 15. This poster describes the extent to which prescription drug plans serving persons dually eligible for Medicare and Medicaid impose utilization management strategies to restrict access of persons with serious mental illness (SMI) to psychotropic and somatic drugs. This is important because, since 2006, persons with SMI were switched from Medicaid drug coverage to coverage managed by private plans under the newly established Part D program.