Patient Access for a Healthy Texas Coalition Announced

Managed Care Weekly Digest

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Essential patient protections in the state Medicaid system are due to expire next year. In response, patient advocates and health care groups are joining together to urge Texas lawmakers to extend these patient protections. The threat to vulnerable patients' access to effective medicine is too great to let these protections expire (see also Patient Access for a Healthy Texas).

Insurance companies are asking Texas legislators to grant them total control over patient access to medications in the Medicaid program under the guise of cost savings. However, the insurers' plan targets Texas' most vulnerable patients and could force them, even if they are already stable on medications, to lose coverage for that prescription and force them into taking medications that may be less effective or even ineffective.

In order for the insurers' plan to produce projected cost savings, it calls for the forced utilization of older technologies as well as adding requirements that patients "fail first" on older drugs before they are allowed to have access to medications prescribed by their doctor.

"Texans' with disabilities access to essential medications is in jeopardy," said Chase Bearden, Director of Advocacy & Community Organizing, Coalition of Texans with Disabilities. "This makes the formation of this coalition crucial, as patients also need to be assured that doctor-patient choice of medicines, consumer protections and a clear and simple prior authorization process will remain the priority. We encourage Texas lawmakers to extend these patient protections."

"Insurance companies are thinking about their bottom line but not what is best for patients or the State of Texas, which already has a lower cost per enrollee for medications than 45 of the 50 states," said Greg Hansch, Public Policy Director, NAMI (National Alliance on Mental Illness) Texas. "Patients need fewer barriers when it comes to accessing the medications they need and ensuring good continuity of care."