Medicaid Policies for HIV-Related Prescription Drugs

As State Medicaid programs become increasingly important sources of payment for acquired immunodeficiency syndrome (AIDS)-related care, and drug regimens the major weapons available to fight human immunodeficiency virus (HIV)-related illnesses, Medicaid drug policies will have a substantial impact. State Medicaid programs were surveyed to identify policies on a range of prescription drug policies affecting these recipients. All Medicaid programs provide prescription drug benefits to all categorically needy recipients, and about three-fourths of the States provide these benefits to medically needy recipients. However, utilization limits, copayments, and off-label-use and prior-authorization policies in many States weaken the drug benefit available.