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Medicaid Demo’s Formularies Include Protections For HIV, Behavioral Health Drugs

 
• By Nielsen Hobbs

Healthy Adult Opportunity initiative (don’t call it block grants) adopts some, but not all, of Medicare Part D’s protected classes, allowing states to exclude some drugs from coverage in the expansion Medicaid population to drive additional savings.

Seema Verma speaks at HHS Medicaid HAO reform briefing on 30 January 2020
CMS Administrator Seema Verma outlines the Medicaid HAO initiative during at briefing at HHS on 30 January 2020. • Source: Screenshot of HHS webcast

States which participate in the Medicaid demonstration unveiled by the Trump Administration on 30 January will be able to create limited formularies that include protected classes for HIV and behavioral health products.

The administration’s Healthy Adult Opportunity (HAO) initiative offers states more flexibility in how they provide Medicaid to the Obamacare expansion...

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