Avoiding Pharmageddon: Helping Patients Stay on their Medications Through their Transitions

November 20, 2013Kathleen Clanon, MD

Sophy Wong, MD

Tjost at Woot!

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Interactive Panels

Raise

Hand

Mute

Chat

Participant Evaluation Form (PEF)

At the conclusion of today’s session, please use the following URL LINK

to complete your participant evaluation form:

3

We will also email the link to you as well.

https://aetcnec.virtualforum.com/pefidform.cfm?erid=24997&sc=533834&aetccode=12

Avoiding Pharmageddon: Helping Patients Stay on their Medications Through their Transitions

November 20, 2013Kathleen Clanon, MD

Sophy Wong, MD

Tjost at Woot!

Objectives

StrategiesPharmageddon

What is still unclear?

Bad Medi-Cal letter

Bad Medi-Cal letter

Legal immigrants <5 years and <138% FPL

…are now are eligible to enroll in

state-funded Medi-Cal!

Legal immigrants <5 years and <138% FPL

…What’s going to happen to Maria?

-In US since 2010-Makes $10k/year

Alameda Alliance is not yet approved as a Covered CA plan.

…stay tuned to see if they will be available starting in Feb/March 2014 (patients can consider waiting).

Alameda Alliance is not yet approved as a Covered CA plan.

…What’s going to happen to John?

-US citizen-Makes $18k/year-Oncologist only takes Alameda Alliance

Pharmageddon

Tjost at Woot!

Pharmageddon

Pharmageddon

Pharmageddon

Pharmageddon

Lost in the Managed Care Crowds

.

Pharmageddon

AvoidingHPAC to Medi-Cal transitions

1. Timely authorizations2. Emergency 72 hour supply3. Non-formulary drug stabilization4. Carve-out for mental health and substance abuse medications

Pharmageddon

Formularies Matter: Medi-Cal plans

Alameda Alliance vs HPAC•17 unique drugs not covered•40% of the covered drugs require PA and additional documentation (ie: step therapy)

Blue Cross vs HPAC•2 unique drugs not covered•3% of the covered drugs require PA

1. Remind patients to bring in mail

2. Know who needs Covered CA and Medi-Cal enrollment

3. Know your enrollment counselors

Strategies you can use!

What is your plan?

Questions? Comments?

East Bay AIDS Education & Training Center

Sophy Wong, MD, Medical Director

Shailey Merchant Klinedinst, MPH, Program Manager

Gracie Askew, Training Manager

(510) 835-3700 phone(510) 625-9307 fax

www.eastbayaetc.org

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Participant Evaluation Form (PEF)

Please use the following URL to complete your participant evaluation form:

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We will also email the link directly to you as well.

Thanks!

https://aetcnec.virtualforum.com/pefidform.cfm?erid=24997&sc=533834&aetccode=12