Medicaid Narcotic Prescription Abuse Act Exposed

The Medicaid Narcotic Prescription Abuse Act is a draft policy introduced by ALEC's Health and Human Services Task Force at the States and Nation Policy Summit on December 2, 2016. (Accessed January 4, 2017).

ALEC Bill Text

Model Legislation

Summary

This Act makes it unlawful for state Medicaid to pay for prescription narcotic drugs under DEA Schedules II, III, and IV. These drugs are still available for any and all Medicaid patients, but will not be paid for by Medicaid funds. These drugs will still be paid for, however, if administered in an emergency medical facility, hospital, or outpatient medical facility.

Section 1. Title

This Act shall be known as the Medicaid Narcotic Prescription Abuse Act.

Section 2. Purpose

The purpose of this Act is to decrease the usage of prescription narcotics via the non-payment for such prescriptions by state Medicaid or any of its managed care entities. This Act does NOT make such prescriptions unavailable to Medicaid recipients and does not criminalize either patients or physicians for writing and filling such prescriptions in a lawful manner. It simply means that state Medicaid will no longer pay for such prescriptions which are still fully available to all patients. This Act also does NOT prevent payment for narcotics that are administered in an Emergency facility, Outpatient Medical Facility, or Hospital. This Act simply decreases the extraordinary pressures upon physicians to yield to Medicaid patient demands for real or fabricated pain control. It likewise will save considerable money in drug costs as well as dependency addiction treatment costs.

Section 3. Definitions

Prescription Narcotics are those drugs appearing on Federal Drug Enforcement Administration (DEA) Schedules II, III, and IV. (Schedule I drugs have no acceptable medical use. Schedule V drugs have a lower risk of dependency)

State Medicaid is a state Medicaid program including any managed care entity or other related program that is administered through state Medicaid.

Section 4. The Medicaid Narcotic Prescription Abuse Act.

This Act makes it unlawful for state Medicaid to pay for prescription narcotic drugs under DEA Schedules II, III, and IV. These drugs are still available for any and all Medicaid patients, but will not be paid for by Medicaid funds. These drugs will still be paid for, however, if administered in an emergency medical facility, hospital, or outpatient medical facility.

Section 5. Repealer Clause

Section 6. Severability Clause

Section 7. Effective Date