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Pharmacy Plus Demonstration Initiative Section 1115 demonstration authority may be used to extend pharmacy coverage to certain low-income elderly and disabled individuals who are not otherwise eligible for Medicaid. The demonstrations may offer assistance by providing pharmaceutical products, assisting individuals who have private pharmacy coverage with high premiums and cost sharing, or provide wraparound pharmaceutical coverage to bring private sources of pharmacy coverage up to the level of desired demonstration benefit coverage. The demonstrations may include incentives for individuals with private pharmacy coverage not to drop their existing coverage in favor of demonstration pharmacy coverage. States are encouraged to adopt competitive private sector approaches to provide more cost effective, modern prescription drug benefits in Medicaid. The demonstrations will test how provision of a pharmacy benefit to a non-Medicaid covered population will affect Medicaid costs, utilization, and future eligibility trends.
Page Last Modified: 01/18/2006 3:52:00 PM
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