News in brief - April 21, 2003

Federal court upholds Michigan Medicaid drug program - CMS names deputy chief medical officer - Medicare drug benefit offers savings for Medicaid

Federal court upholds Michigan Medicaid drug program

The U.S. District Court for the District of Columbia has ruled in favor of a Michigan program designed to try to save money on prescription drugs in Medicaid. Under the program, doctors must get special permission to prescribe Medicaid patients medications that are not on the state's preapproved list.

The Pharmaceutical Research and Manufacturers of America and other groups that filed the lawsuit against the Dept. of Health and Human Services have vowed to appeal the district court's ruling.

CMS names deputy chief medical officer

The Centers for Medicare & Medicaid Services has hired William K. Sullivan, MD, a veteran public health official from Maine, as deputy chief medical officer.

Dr. Sullivan will advise senior CMS leaders on health care quality and medical science issues while representing CMS to outside organizations seeking guidance on clinical questions involving Medicare.

"I am really excited to be bringing in another experienced practicing physician to CMS," said the agency's administrator, Tom Scully. "Dr. Sullivan brings a rich background in clinical and policy experience to the world's biggest insurance company -- CMS."

Since 1995, Dr. Sullivan has served as vice president for medical affairs and chief clinical officer for the Eastern Maine Medical Center in Bangor. He is a graduate of the U.S. Military Academy and the University of Missouri-Columbia School of Medicine.

Medicare drug benefit offers savings for Medicaid

A Medicare outpatient prescription drug benefit could save states up to $6.8 billion annually -- money that could be used to avoid planned cuts in Medicaid eligibility and benefits, according to a new report from the Commonwealth Fund.

State Medicaid programs cover about 6 million low-income seniors and people with disabilities who qualify for both Medicare and Medicaid coverage. These dual-eligibles accounted for nearly half of the $16 billion Medicaid programs spent on drugs in 2002.

The amount of relief states would garner from a Medicare drug benefit would depend in large part on how much responsibility remains with states for covering cost-sharing for its dual-eligibles.

Each $1 billion in savings could provide coverage for 1 million low-income adults under age 65 or more than 1.5 million children, the researchers said.