Pharmaceutical Benefits Under State Medical Assistance Programs, 2003


This report, part of the Pharmaceutical Benefits Under State Medical Assistance Programs series, is a compilation of data under state medical assistance programs (Title XIX) or state public medical assistance programs (prior Titles of the Social Security Act). It presents a general overview of the characteristics of state programs together with more detailed information on the pharmaceutical benefits provided. The data collection effort covers all states with Medicaid programs.

The information in this book is summarized in the following sections:

  • Section 1: Reports on the Medicare Modernization Act provisions, the dual eligibles it will affect, and the overall impact on the States.
  • Section 2: Overview of the Medicaid program, details about Medicaid managed care enrollment, including a breakdown by plan type and enrollment by plan type and a synopsis of 1915(b) waivers and 1115 demonstrations.
  • Section 3: Socio-demographic statistics and a description of the Medicaid certified facilities in each state.
  • Section 4: Medicaid pharmacy program characteristics, drawn largely from the NPC annual survey of state program administrators.
  • Section 5: Detailed profile of the states’ Medicaid pharmacy program (including medical assistance benefits and eligibles, drug payments and recipients, benefit design, pharmacy payment and patient cost sharing, use of managed care and state contacts.
  • Section 6: Profiles of the “expanded” drug programs in States that are providing pharmaceutical coverage or discounts to the elderly and/or disabled persons.