State Alerts

 
 Legislative Summary Feb 2005
 
NAMI-Madison County Legislative Update February 14, 2005

 
Mental Health Carve- Out Bill

Introduced by Rep. William Delgado, HB 0734 is a mental health carve-out bill that would not impose prior approval restrictions for antidepressants or other drugs to treat serious mental illness for Medicaid recipients. The carve-out bill (HB 0734) has been assigned to the House Executive Committee. See Committee Action below.

Call members of the House Executive Committee and Urge Them to Vote "Yes" on HB 0734
 Open access to mental health drugs is essential to treating mental illness. It's not cost effective for the state to limit Medicaid patients' choice of mental health medications.
BACKGROUND:

              Open Access is Essential to Treating Mental Illness         
    
We should not subject Medicaid patients to a lower standard of care by limiting their treatment options for mental illness.  The IL Department of Public Aid should maintain an open formulary for mental health drugs so physicians, not bureaucrats, can decide what medications their patients need.           
    
Medications for the mentally ill are not interchangeable.  Many drugs, while similar in pharmacological properties, may result in different side effects in different people.                                                    
    
It can often take much trial and error to find the right treatment for depression.  According to a recent survey by Consumer Reports, more than 50% of people who took anti-depressants tried two or more drugs before finding the one that worked for them.                                           
                              
    
      A Restrictive Formulary Does Not Make Fiscal Sense for Illinois   
     
The economic reality is that restricting access to mental health medications only results in higher Medicaid spending for services such as emergency room visits, inpatient  admissions, partial hospitalizations,  and physician visits.                                                                 
    
When California's Medicaid program tried to contain costs through restrictive formularies, the average prescription cost per patient increased from $245 to $726, and the average number of physician office visits increased from 3.2 to 6.6.      
                                                                         
The following states have exempted mental health medications from access restrictions:  California, Connecticut, Florida, Hawaii, Indiana, Kansas, Michigan, Minnesota, Oregon, Pennsylvania, South Carolina, Vermont, Virginia and Washington.                                                         
    
               Favoring Generic Drugs Is Not Always Cost-Effective         
     
Patients on newer anti-depressants generally experience fewer and less troubling side effects than patients on older drugs and so are consequently far more likely to adhere to their medications.                         
    
A study in the American Journal of Managed Care found that early discontinuation of anti-depressant therapy results in an increased cost of more than $2200 per patient annually, compared to patients who stay on a therapy for more than 90 days.  The financial impact is even greater
when patients switch anti-depressant therapies, resulting in an increased cost of $4197 per patient.      
                             
According to a 2001 study by a Columbia University researcher, a $1 expenditure on newer medications translates into a $3.65 reduction in hospital costs, physician visits and other healthcare services.         
    
For every dollar invested in mental health treatment, including medication, $3-$8 is saved through the reduction in criminal activity and hospitalization. 
 
Committee Action:
 HB 0734 was assigned to the House Executive Committee on 2/8/2005.

TAKE ACTION:  Please call members of the House Executive Committee NOW at their district office and ask for a "Yes" vote on House Bill 0734. Please make your call no later than Friday, February 18th. 

LEAVE THIS MESSAGE:  (If members are not in their office at the time of your call)
"Please vote "Yes" on House Bill 0734. Open access to mental health drugs is essential to treating mental illness. It's not cost effective for the state to limit Medicaid patients' choice of mental health medications.

House Executive Committee Members:  
Chairperson: Rep. Daniel Burke
 District Office: 773-471-2299


 Rep. Edward Acevedo
 District Office: 773-843-1200
 Rep. Maria Antonia Berrios
 District Office: 773-486-6488
 Rep. Bob Biggins
 District Office: 630-941-1278
 Rep. Richard Bradley
 District Office:773-794-9444
 Rep. Brent Hassert
 District Office: 630-739-7063

 Rep. Lovana Jones
 District Office: 773-373-9400
 Rep. Renee Kosel
 District Office: 708-479-4200
 Rep. Eileen Lyons
 District Office:708-352-7700
 Rep. Joseph Lyons
 District Office: 773-283-8594
 Rep. Larry McKeon
 District Office: 773-348-3434
 Rep. Robert Molaro
 District Office: 773-838-1212
 Rep. Angelo Saviano
 District Office: 708-453-7547
Much, much thanks to you all for all your work!!!

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You can check this bill’s wording and status on the Illinois General Assembly web site:  http://www.ilga.gov/

Any questions, contact either Sandy Giger at 644-5705, skgiger@hotmail.com or Mary Gauen at 288-4376, katiegauen@charter.net
Date Modified: Saturday December 31, 2005