Spillover effects of state medicaid antipsychotic prior authorization policies in US commercially insured youth

2020 ◽  
Vol 29 (9) ◽  
pp. 1064-1071
Author(s):  
O'Mareen Spence ◽  
Gloria Reeves ◽  
Susan dosReis
Keyword(s):  
Spillover Effects ◽  
Prior Authorization ◽  
Authorization Policies

scholarly journals Medicaid Prior Authorization Policies for Medication Treatment of Attention-Deficit/Hyperactivity Disorder in Young Children, United States, 2015

2017 ◽  
Vol 132 (6) ◽  
pp. 654-659 ◽  
Author(s):  
Rachel L. Hulkower ◽  
Meghan Kelley ◽  
Lindsay K. Cloud ◽  
Susanna N. Visser
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
American Academy ◽  
Behavior Therapy ◽  
Attention Deficit ◽  
Adhd Medication ◽  
Prior Authorization ◽  
Medication Treatment ◽  
Hyperactivity Disorder ◽  
American Academy Of Pediatrics ◽  
Authorization Policies

Objectives: In 2011, the American Academy of Pediatrics updated its guidelines for the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) to recommend that clinicians refer parents of preschoolers (aged 4-5) for training in behavior therapy and subsequently treat with medication if behavior therapy fails to sufficiently improve functioning. Data available from just before the release of the guidelines suggest that fewer than half of preschoolers with ADHD received behavior therapy and about half received medication. About half of those who received medication also received behavior therapy. Prior authorization policies for ADHD medication may guide physicians toward recommended behavior therapy. Characterizing existing prior authorization policies is an important step toward evaluating the impact of these policies on treatment patterns. We inventoried existing prior authorization policies and characterized policy components to inform future evaluation efforts. Methods: A 50-state legal assessment characterized ADHD prior authorization policies in state Medicaid programs. We designed a database to capture data on policy characteristics and authorization criteria, including data on age restrictions and fail-first behavior therapy requirements. Results: In 2015, 27 states had Medicaid policies that prevented approval of pediatric ADHD medication payment without additional provider involvement. Seven states required that prescribers indicate whether nonmedication treatments were considered before Medicaid payment for ADHD medication could be approved. Conclusion: Medicaid policies on ADHD medication treatment are diverse; some policies are tied to the diagnosis and treatment guidelines of the American Academy of Pediatrics. Evaluations are needed to determine if certain policy interventions guide families toward the use of behavior therapy as the first-line ADHD treatment for young children.

5.56 ANTIPSYCHOTIC MEDICATION PRESCRIPTION TRENDS IN FOSTER CARE CHILDREN ENROLLED IN ARKANSAS MEDICAID FOLLOWING IMPLEMENTATION OF PRIOR AUTHORIZATION POLICIES

2016 ◽  
Vol 55 (10) ◽  
pp. S201-S202 ◽  
Author(s):  
Stacy Simpson ◽  
Steven Domon ◽  
Laurence H. Miller ◽  
Pamela Ford-Bowen ◽  
William Golden ◽  
...  
Keyword(s):  
Foster Care ◽  
Antipsychotic Medication ◽  
Prior Authorization ◽  
Medication Prescription ◽  
Authorization Policies

scholarly journals Medicaid Prior Authorization Policies for Pediatric Use of Antipsychotic Medications

JAMA ◽  
2015 ◽  
Vol 313 (9) ◽  
pp. 966 ◽  
Author(s):  
Ian Schmid ◽  
Mehmet Burcu ◽  
Julie M. Zito
Keyword(s):  
Prior Authorization ◽  
Antipsychotic Medications ◽  
Authorization Policies ◽  
Pediatric Use

Economic Impact of Prior Authorization Policies for Atypical Antipsychotics in the Treatment of Schizophrenia

2010 ◽  
Vol 13 (5) ◽  
pp. 247-254 ◽  
Author(s):  
Safiya Abouzaid ◽  
Eric Jutkowitz ◽  
Kathy A. Foley ◽  
Laura T. Pizzi ◽  
Edward Kim ◽  
...  
Keyword(s):  
Economic Impact ◽  
Atypical Antipsychotics ◽  
Prior Authorization ◽  
Authorization Policies

Differential Effect of Early or Late Implementation of Prior Authorization Policies on the Use of Cox II Inhibitors

Medical Care ◽  
2006 ◽  
Vol 44 (4) ◽  
pp. 378-382 ◽  
Author(s):  
Elizabeth E. Roughead ◽  
Fang Zhang ◽  
Dennis Ross-Degnan ◽  
Stephen Soumerai
Keyword(s):  
Differential Effect ◽  
Prior Authorization ◽  
Authorization Policies

3.51 IMPACT OF PRIOR AUTHORIZATION POLICIES ON ANTIPSYCHOTIC MEDICATION PRESCRIPTION TRENDS IN PRESCHOOL-AGE CHILDREN ENROLLED IN ARKANSAS MEDICAID

2016 ◽  
Vol 55 (10) ◽  
pp. S158
Author(s):  
Stacy Simpson ◽  
Steven Domon ◽  
Laurence H. Miller ◽  
Pamela Ford-Bowen ◽  
William Golden ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Preschool Age ◽  
Prior Authorization ◽  
Medication Prescription ◽  
Preschool Age Children ◽  
Authorization Policies

scholarly journals Impact of two Medicaid prior-authorization policies on antihypertensive use and costs among Michigan and Indiana residents dually enrolled in Medicaid and Medicare: Results of a longitudinal, population-based study

2010 ◽  
Vol 32 (4) ◽  
pp. 729-741 ◽  
Author(s):  
Michael R. Law ◽  
Christine Y. Lu ◽  
Stephen B. Soumerai ◽  
Amy Johnson Graves ◽  
Robert F. LeCates ◽  
...  
Keyword(s):  
Population Based ◽  
Prior Authorization ◽  
Population Based Study ◽  
Authorization Policies
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