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Improving Access to Drugs for Medicare Beneficiaries
Can State Law Help?
California law SB393, enacted in 1999, mandates that Medicare beneficiaries who present their Medicare cards to pharmacies participating in the state Medicaid program (known as Medi-Cal) must be offered name-brand prescription medications at prices that do not exceed the Medi-Cal reimbursement rate for those medications. To address concerns as to whether the legislation was meeting its goal, RAND researchers assessed pharmacy compliance in California's two largest metropolitan areas. They also assessed the potential savings to beneficiaries under the law. They found that about 75 percent of the pharmacies offered the discount, but compliance varied considerably among the pharmacies. The ease with which patients were able to obtain the discount also varied. Finally, Medi-Cal prices offered a substantial cost savings: 21-29 percent for the three drugs studied.
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