Author: PCG | Posted: 6. August 2010 05:03

Kentucky has released a plan estimated to save $87 million in state and federal Medicaid expenditures in state fiscal year 2011. Key elements in Kentucky’s plan include reimbursing pharmacies only for drugs prescribed by currently Medicaid enrolled practitioners; promoting greater substitution of generic drugs for more costly brand name drugs; locking Medicaid recipients with unusually high costs (relative to their medical conditions) into an accessible primary care provider, a community pharmacy, and a local hospital for all non-emergency care; reducing payments for services related to infections and other conditions acquired in the same facility, as Medicare does;  increasing enrollment of Medicaid recipients into employer-based group health plans; requiring that certain medical supplies be dispensed through pharmacies exclusively, to increase Kentucky’s rebate recoveries from manufacturers; increasing use of Kentucky’s Medicaid Management Information System (MMIS) and computer modeling to uncover patterns of program abuse and fraud; and recovering Medicaid overpayments via a tax refund intercept program under an agreement with the Kentucky Department of Revenue. Kentucky’s plan uses intensive Medicaid program, service utilization, and regulatory analysis to design ways to improve efficiency and to promote appropriate patterns of care.