5.56 ANTIPSYCHOTIC MEDICATION PRESCRIPTION TRENDS IN FOSTER CARE CHILDREN ENROLLED IN ARKANSAS MEDICAID FOLLOWING IMPLEMENTATION OF PRIOR AUTHORIZATION POLICIES

2016 ◽  
Vol 55 (10) ◽  
pp. S201-S202 ◽  
Author(s):  
Stacy Simpson ◽  
Steven Domon ◽  
Laurence H. Miller ◽  
Pamela Ford-Bowen ◽  
William Golden ◽  
...  
2017 ◽  
Vol 132 (6) ◽  
pp. 654-659 ◽  
Author(s):  
Rachel L. Hulkower ◽  
Meghan Kelley ◽  
Lindsay K. Cloud ◽  
Susanna N. Visser

Objectives: In 2011, the American Academy of Pediatrics updated its guidelines for the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) to recommend that clinicians refer parents of preschoolers (aged 4-5) for training in behavior therapy and subsequently treat with medication if behavior therapy fails to sufficiently improve functioning. Data available from just before the release of the guidelines suggest that fewer than half of preschoolers with ADHD received behavior therapy and about half received medication. About half of those who received medication also received behavior therapy. Prior authorization policies for ADHD medication may guide physicians toward recommended behavior therapy. Characterizing existing prior authorization policies is an important step toward evaluating the impact of these policies on treatment patterns. We inventoried existing prior authorization policies and characterized policy components to inform future evaluation efforts. Methods: A 50-state legal assessment characterized ADHD prior authorization policies in state Medicaid programs. We designed a database to capture data on policy characteristics and authorization criteria, including data on age restrictions and fail-first behavior therapy requirements. Results: In 2015, 27 states had Medicaid policies that prevented approval of pediatric ADHD medication payment without additional provider involvement. Seven states required that prescribers indicate whether nonmedication treatments were considered before Medicaid payment for ADHD medication could be approved. Conclusion: Medicaid policies on ADHD medication treatment are diverse; some policies are tied to the diagnosis and treatment guidelines of the American Academy of Pediatrics. Evaluations are needed to determine if certain policy interventions guide families toward the use of behavior therapy as the first-line ADHD treatment for young children.


JAMA ◽  
2015 ◽  
Vol 313 (9) ◽  
pp. 966 ◽  
Author(s):  
Ian Schmid ◽  
Mehmet Burcu ◽  
Julie M. Zito

2010 ◽  
Vol 13 (5) ◽  
pp. 247-254 ◽  
Author(s):  
Safiya Abouzaid ◽  
Eric Jutkowitz ◽  
Kathy A. Foley ◽  
Laura T. Pizzi ◽  
Edward Kim ◽  
...  

Medical Care ◽  
2006 ◽  
Vol 44 (4) ◽  
pp. 378-382 ◽  
Author(s):  
Elizabeth E. Roughead ◽  
Fang Zhang ◽  
Dennis Ross-Degnan ◽  
Stephen Soumerai

2019 ◽  
Vol 58 (10) ◽  
pp. S251-S252
Author(s):  
William David Lohr ◽  
Yana Feygin ◽  
Kahir Jawad ◽  
Liza Creel ◽  
Jennifer F. Le ◽  
...  

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