Tennessee: Running Out of Medicine: TennCare Patients Check Options
July 29, 2005
Effective Monday, Aug. 1, about 288,000 Tennessee residents will no longer receive prescription drug coverage through TennCare. For those remaining on the program, a limit of five prescriptions per month will be imposed; no more than two may be brand-name drugs.
Gov. Phil Bredesen said the changes are required to curb rising state costs and save funds for education and other programs. The average TennCare recipient has 30 prescriptions annually, said state officials.
Marilyn Elam, a TennCare spokesperson, said certain drugs, including those to treat cancer and HIV infection, will not be counted against the monthly limit. But some patients are wondering what exactly won't be covered.
TennCare has allocated $15 million to provide former clients with a discount drug card as well as access to 58 generic medicines at no cost through year's end. The state has also promised to supply supplemental drug coverage for patients with severe, persistent mental illness.
A handful of public and private clinics offer a federal program discounting drugs at 50-60 percent of their retail price. Other clinics and private practitioners will help patients transition into pharmaceutical industry programs. A drug industry clearinghouse Web site can direct patients to more than 350 public and private programs for some low-cost prescription drugs, but generics are not listed.
"I think of it as a fallback measure," Sita Diehl, executive director of the National Alliance for the Mentally Ill of Tennessee, said of the state's efforts to help uninsured residents. Diehl is concerned whether every patient will be able to sort through the new drug options and navigate the process. "I thought TennCare was a large step forward and this is a large step back," she said.
Commercial Appeal (Memphis, Tenn.)
07.25.2005; Mary Powers