Pharmaceutical Benefitsunder State Medical AssistancePrograms
2000
Published by theNational Pharmaceutical Council, Inc.1894 Preston White DriveReston, VA 20191-5433
©
2000 by the National Pharmaceutical Council
This compilation of data on State Medical Assistance Programs (Title XIX) presents a general overview of the characteristics of state programs, together with detailed information on the pharmaceutical benefits provided. The datacollection effort covers all states with Medicaid programs and the District of Columbia.Information for this compilation was acquired from multiple sources, including asurvey of Medicaid prescription drug programs, administered for the NationalPharmaceutical Council by The Lewin Group, Falls Church, Virginia. While wehave checked all secondary data in the book for consistency relative to theoriginal source, we have not validated the original data reported by the HealthCare Financing Administration (HCFA) and other organizations.The data were compiled and the book prepared for publication by CatherineHarrington, Dawn Bartoszewicz, Corinna Sorenson, Haejin Chung and SheelaRaju of The Lewin Group; and Kimberly Dietrich of the NationalPharmaceutical Council.
Pharmaceutical Benefits 2000 National Pharmaceutical Counciliii
INTRODUCTION
The year 2000 edition of
Pharmaceutical Benefits under State Medical Assistance Programs
marks the 35
th
year that the National PharmaceuticalCouncil (NPC) has published this unique source of information on pharmacy programs within the State Medical Assistance Programs (Title XIX). Over theyears, this “Medicaid Compilation” of statistics has become a standard referencein government offices, research libraries, consultancies, and numerouscorporations.The “Medicaid Compilation” incorporates information on each State pharmacy program from an annual NPC survey of State Medicaid program administratorsand pharmacy consultants and statistics from the Health Care FinancingAdministration (HCFA). A main data source of the compilation, the HCFA-2082, is an annual report providing State-reported data on Medicaid populationcharacteristics and utilization during a Federal fiscal year.Historically, states summarized and reported data processed through their Medicaid claims processing and payment operations unless they opted to participate in the Medicaid Statistical Information System (MSIS) project. Prior to Federal fiscal year 1999, MSIS was a voluntary program where states participating in the MSIS project provided data tapes from their claims processing systems to HCFA in lieu of the 2082 tables. In accordance with theBalanced Budget Act of 1997, all claims processed on or after January 1, 1999,had to be submitted electronically in the MSIS format. This new requirementhas caused some states to have difficulty providing data to HCFA within thenormal timeframe, which has resulted in a delay in the release of the HCFA-2082 report for fiscal year 1999.Because of this delay, the NPC is presenting this preliminary draft of the“Medicaid Compilation, 2000” in Adobe Portable Document Format (PDF).This preliminary draft contains the latest information provided by StateMedicaid program administrators and pharmacy consultants for Federal fiscalyear 1999, however, it still contains Medicaid population characteristics andutilization based on the 1998 HCFA-2082 report. Once the HCFA-2082 reportfor fiscal year 1999 is released by HCFA, the NPC and The Lewin Group willupdate the information and make the full printed edition of the book available.In order to give a better understanding of the content of the “MedicaidCompilation,” the information contained in this version of the book issummarized below by section:
•
Section 1: Reports on the trends in of Medicaid expenditures over the lastdecade (through 1999, the last year data are available) and highlightsdifferences between Medicaid and national spending.
•
Section 2: Contains details about Medicaid Managed Care enrollment as of June 30, 1999, including a breakdown by plan type and enrollment by plantype.
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