Monday, October 27, 2008

Asthma trigger

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Some points of contention
The West Virginia program is more controversial than other states' because it automatically bounces nonparticipating beneficiaries -- possibly without their knowledge -- into the basic plan. Once there they encounter more restrictions than in traditional Medicaid, such as caps on prescriptions and mental health services.
For example, children in the basic plan are limited to four prescriptions per month, even though a child with asthma and attention deficit disorder could easily hit that limit, said Fernando Indacochea, MD, president of the West Virginia Chapter of the American Academy of Pediatrics. Landrum, however, said a state review of data from three pilot counties prior to implementation showed that children on Medicaid average fewer than one prescription a month.
And while individual mental health therapy is covered under the basic plan, crisis intervention is not, said Bob Hansen, executive director of Prestera Center, a mental health and addictions treatment agency in Huntington.
Georgetown University's Center for Children and Families on Aug. 9 issued a paper criticizing the state for automatically limiting kids' benefits via the basic plan. If the program aims to encourage healthy behaviors among Medicaid enrollees, said Joan Alker, the deputy executive director of the center, 'I don't think there's any evidence that they're achieving that.'
West Virginia already has learned some lessons that could be applied by other states considering incentives for patient compliance



'We are hoping to do research using data on our population and to stop (quoting) this World Health Organisation,' he said.
No doubt, it is the NHF's reach into the community which earned it a nomination for a Gleaner Honour Award in the health and wellness category. Fifteen chronic conditions (including cancer, diabetes, hypertension and other cardiovascular diseases, epilepsy, depression, psychosis, glaucoma, asthma, arthritis and prostate enlargement) are covered by the NHF which is financed through a tobacco tax, an NHF deduction and the Government's consolidated fund. The NHF makes a fixed payment towards approved prescription drugs. The beneficiary pays the difference



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