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Published Online: 4 February 2005

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

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Published online: 4 February 2005
Published in print: February 4, 2005

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