12. February 2012 by admin.

NAMI would like to hear from you… Answer a survey.

here are the question they would like to know about:

Access to Medication 

Access to Medication
Exit this survey

1. Does your mental health plan enforce prescription limits to mental health medications? In other words are there monthly or a yearly number of mental health prescriptions that you can have filled?

2. If you have been incarcerated, were you released from jail without medications?

3. If you have been incarcerated, were you given medications while in jail?

4. Have you had to skip medications for lack of money to pay for your prescription(s)?

5. Have you ever received free medications from pharmaceutical companies?

6. Have you ever received free medications from pharmaceutical companies?

7. Have you ever used coupons or certificates to obtain medications?

8. Are you aware of programs that offer free medications? If yes, what programs do you know of?

9. If your health care insurance company (HMO, Medicaid/Medicare) changed formularies were you able to stay on your current medication or did it result in a medication change?

10. Has the use of a preffered drug list (formulary) had an impact on your medication access?

11. Has the process of preventing the prescribing of a new medication until a specific medication, an entire medication group, and generic medication has failed (”Fail-First” rule) impaired your ability to adhere to your treatment?

12. Have barriers to medications had an impact on your recovery?

13. Did the health insurance company (HMO, Medicaid/Medicare, etc.) provide your doctor with the PDL policy, the steps the physician is required to prescribe a non-formulary medication?

14. If your physician has prescribed multiple medication for the same diagnosis (polypharmacy) have you had challenges getting access to the medications?

15. If yes, please designate which HMO or insurance company denied access.

16. Patients often have to fail on one or more drugs first before being able to take the drug first before being able to take the drug their physician wanted to prescribe them in the first place. Have you ever had trouble getting access to the medication you needed because of “step therapy” or “fail first” requireements?

17. Sometimes formularies change, and consumers do not know about it. Has the medication you have needed ever not been included on the new formulary?

18. Were your difficulties with “step therapy” and continuity of care due to
Were your difficulties with “step therapy” and continuity of care due to   managed care, like a HMO or a PPO, Medicaid or Private insurance

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30. January 2012 by admin.

In the Sunday, January 29, 2010 Charlotte Sun newspaper that ran an article by Sun Correspondent NEIL HUGHES entitled: “Plan for $2B ($2,000,000,000.00) in Medicaid cuts concerns hospitals“.

“Gov. Rick Scott’s plan to slash about $2 billion from the state’s Medicaid funding has caused concern among some health care officials in Southwest Florida, who fear it will greatly reduce hospitals’ abilities to help the poor. The proposed cuts from Scott amount to about 10 percent of Florida’s Medicaid fund, which provides health care to low-income people, and would take effect in the 2013 budget.“

Reading over the article I couldn’t help but think how this $2 billion cut is going to affect my peers and I living with mental disorders like bipolar disorder, depression, borderline personality disorder, and schizophrenia. I’m all for getting rid of Medicaid fraud but these cuts seen like they’re going to just make it harder to get well needed services.

I agree that there are many that abuse the system and just go to the ER when they get the sniffles or for any little small ailment… That runs up the Medicaid bill substantially in that is where a lot of education needs to be focused on. The article said that the governor will allocate “a portion of that money toward education“. It seems to me that the education should have been done all along. Still in the last few years we have seen in the state of Florida hundreds of thousands of dollars trimmed from services for mentally ill individuals. I wonder what are crime rate is? Did you know Florida or his 49th in the state for spending for mental illness programs and mental health services? Yet, it will surprise you that Florida ranks 12th in the penal system for spending for mental health services and penitentiaries in jails. Then scenario is if you want good mental health services you need to rob a bank. No do not rob a bank! That is a figurative term, do not rob a bank just to get medical services, do not do anything that would be considered fraudulent to get Medicaid to pay for.

now not quite sure what nail was saying in the article and when he said “the proposed cuts from Scott amount to about 10% of slaughters Medicaid fraud”. Does that mean that each year there is $20 billion in Medicaid fraud each year? Since, 10% of 20 billion would equal 2 billion then the article would make a lot more sense. Heck if I could cut down on fraud then I would do what I could I would think any American would.

But who gets hurt in the end here? The ECO Gwen McKenzie of the Sarasota Memorial Hospital estimates that they treat 90% of Sarasota’s Medicaid cases… I.e. 90% of the poor. She says “we are deeply concerned that these devastating cuts will jeopardize our ability to care for the region’s most vulnerable patients“.

In the end the cuts will be done and the poor will stay poor and the rich will get rich, it has been this way since the beginning why would it change now?

This is why it is so important for managed care, self-care, recovery support groups of recovery and resiliency programs for mental health issues.  Support groups when well attended will help not only maintain compliancy but at the same time improve your recovery.  Although I hate the word compliancy I need to use it to indicate improvement. We are living in a time of dire Straits high stress with serious mentally ill people not getting the services they need. We are in fact being left out to the wolves, but fear not if we work together share our experiences and build our one voice we can be heard one day but until then when I have to look out for each other.

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