MONITORING REFORM

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FYI: New York is among 21 states that are planning to add “prior-authorization” procedures to their Medicaid prescription drug benefits in fiscal year 2003 in order to control costs. Under this system, doctors must get permission to prescribe certain meds. In New York, Governor Pataki proposes doing this by setting up a preferred drug list, and requiring prior authorization for anything not on the list. A joint study by the Urban Institute and Kaiser Family Foundation released this week evaluates five existing programs, seeking to fill an information void about how prior authorization effects care. One striking result as relative to New York’s system: States with managed care Medicaid programs have been unable or unwilling to closely monitor how the plans run their own prior authorization processes. [4/23/03]