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October 15, 2021

Health Law Weekly

OIG Looks at Changes Made by State Medicaid Agencies to Ensure Access to Prescriptions During the Pandemic

  • October 15, 2021

State Medicaid programs made various changes to their requirements to ensure beneficiary access to prescription drugs during the COVID-19 pandemic, the Department of Health and Human Services Office of Inspector General (OIG) said in an October 14 report.

To assess the types of changes, OIG created a questionnaire, which was filled out by 24 selected states.

According to the results, 20 of the 24 states that responded implemented changes to prior authorization requirements, one state responded that it planned to implement changes but had not yet done so, and three responded that they did not have plans to implement changes.

In addition, 22 states implemented changes to their policy allowing early refills. The report noted considerable variability in what the states allowed, but generally they relaxed the requirements related to early refill limits so beneficiaries could obtain prescription drug refills earlier than normal.

States also increased beneficiaries’ prescription quantity limits to allow beneficiaries to make fewer trips to a pharmacy during the pandemic. Specifically, 18 states reported they had implemented changes, three responded that they did not plan to implement changes, and three responded that they allowed pharmacies to dispense 90-day (or more) supplies of prescription drugs prior to the COVID-19 pandemic and therefore made no change.

Twenty-one states also reported removing the beneficiary signature requirement upon receipt of a prescription drug.

According to OIG, 20 states implemented changes that give physicians greater flexibility to prescribe drugs to new or established patients using telehealth. The four remaining states said they already had policies permitting flexibility to prescribe drugs using telehealth before the COVID-19 pandemic.

The report noted that all 24 states indicated they provided updated guidance through various means to providers, pharmacies, Medicaid beneficiaries, and managed care organizations.

The information gleaned from the report was provided to the Centers for Medicare & Medicaid Services and states.

Read the report, Changes Made to States' Medicaid Programs To Ensure Beneficiary Access to Prescriptions During the COVID-19 Pandemic (A-06-20-04007).



  • Coronavirus Pandemic