Medicare Part D Plans Blocking Access to Mental Health Drugs: Plans Vary Widely on Utilization Management Restrictions

OPEN MINDS, The Behavioral Health & Social Service Industry Analyst Industry Feature Despite regulations aimed at ensuring access to all medically necessary drugs, patients enrolled in Medicare Part D plans are finding utilization management (UM) restrictions are limiting their access to several types of generic and name-brand medications. All Medicare Part D plan providers cover substantially all mental health drugs. However, many plans have either failed to provide coverage or have instituted UM techniques that restrict consumer access to antidepressant and antipsychotic medications. This is bad news for the nearly 2.5 million dual eligibles (individuals with both Medicare . . .