Medicaid in Kentucky will no longer pay for name-band aspirin and other over-the-counter medications when generic options are available.
The Kentucky Department for Medicaid Services is implementing that and other changes intended to save some $87 million while having only minimal affects on recipients, doctors and other medical care providers.
Medicaid Commissioner Elizabeth Johnson said the move is intended to curb waste, fraud and abuse in the program that provides medical care to the poor and disabled.
Another key change Johnson announced will allow the Medicaid program to reimburse only approved physicians for prescriptions, a move intended to ensure the state isn’t paying for drugs for unscrupulous recipients who may be abusing or selling them on the streets.
“These commonsense changes serve to enhance the integrity of the program, support quality practice by participating providers and continue to provide appropriate and quality care for recipients,” Johnson said in a statement.
Recipients also will be required to use 90 percent of their medication before getting refills. Previously, they could get refills after taking 80 percent of their medication. Johnson said that move will discourage stockpiling medications and reduce the likelihood of illegal resale of the pills.
Some 800,000 Kentuckians are enrolled in the Medicaid program at a cost of about $6 billion a year.
Johnson said the current budget requires Medicaid to reduce its spending by more than $500 million. The changes announced Friday, she said, are a first step toward meeting that mandate.
Even deeper cuts, Johnson said, will be necessary without federal financial help.
Kentucky lawmakers passed a budget earlier this year that included $238 million that they expected Congress to appropriate for Medicaid and jobless benefits. Those funds were blocked in June by a Republican filibuster in the Senate, and Gov. Steve Beshear has asked department heads to begin looking for ways to cut the budget.
Beshear has been lobbying Kentucky’s federal delegation to push for the money. He said Congress needs to understand the “critical need” that Kentucky and other cash-strapped states have for the federal help.