Clearing Hurdles & Hitting Walls: Restrictions Undermine Part D Coverage of Mental Health Drugs

September 2006 Clearing Hurdles & Hitting Walls: Restrictions Undermine Part D Coverage of Mental Health Drugs Despite instruction from the Centers for Medicare and Medicaid Services (CMS) to Medicare Part D plan providers to cover substantially all mental health drugs, many plans either have failed to provide coverage or have instituted utilization management techniques that restrict consumer access to antidepressant and antipsychotic medications. On average, nearly 23% of common antidepressant medications and nearly 24% of common antipsychotic medications were subject to utilization management or were absent from Part D plan formularies. Many plans apply utilization management differently depending on the . . .