What the Law Says
Medicaid programs have long had the authority to exclude specific classes of drugs from coverage, including benzodiazepines. Yet 41 of the 50 states cover benzodiazepine prescriptions through Medicaid or another state drug program. The Medicare Prescription Drug Improvement and Modernization Act of 2003 goes one step further, making the exclusion mandatory.
These are the nine categories of medications that may be excluded under Medicaid and must be excluded from coverage under Medicare Part D:
Agents used for anorexia, weight loss, or weight gain | |||||
Agents used to promote fertility | |||||
Agents used for cosmetic purposes or hair growth | |||||
Agents used for the symptomatic relief of cough and colds | |||||
Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations | |||||
Nonprescription drugs | |||||
Outpatient drugs for which the manufacturer seeks to require that associated tests or monitoring services be purchased exclusively from the manufacturer or its designee as a condition of sale | |||||
Barbiturates | |||||
Benzodiazepines | |||||
