DENVER — In an effort to cut costs, Colorado will start limiting low-income patients to eight prescription drugs at a time starting Friday, a plan some doctors say could push physicians to stop accepting Medicaid patients.
Under the plan, expected to save Colorado’s Medicaid program $6.6 million a year, doctors who believe they need to prescribe more than eight drugs to a Medicaid patient will have to call a toll-free number for approval first.
Six types of drugs won’t count toward the eight prescriptions: chemotherapy, contraceptives, anti-psychotics, perinatal nutrition therapy, and drugs for diabetes and AIDS.
But Dr. Mark Wallace, of the Weld County Department of Public Health, said there are other illnesses that require several prescriptions, including emphysema, high cholesterol and congestive heart failure.
Some doctors say that added step of calling for approval wastes time that they can’t spare.
“They are hanging in there with Medicaid by a string,” said Robert McCartney, Denver Medical Society president. “You put an extra five minutes of time on them, and that’s enough to make them not want to see these patients anymore.”
The state implemented the program in 18 of its 63 counties on April 1 and will expand it statewide on Friday. It did not require legislative approval. Doctors learned of the new policy in a note at the bottom of their March billing statements.
Dr. Bernard Gipson, a primary-care doctor who practices in an urban Denver neighborhood and sees a lot of Medicaid patients, called the plan “just ridiculous.”
He said he was advising patients to put their eight most expensive drugs on the Medicaid list and try to find generic drugs for other prescriptions. He said he had asked some patients to pay for expensive medicine out of their own pockets because he doesn’t have time to call for approval.
About 320,000 low-income residents participate in Colorado’s Medicaid program. Of those, 7,432 take more than eight prescriptions, including 1,706 who are one drug over the limit.
Some doctors met with Medicaid officials last week and agreed to allow the state to closely track the impact of the new policy for a time.