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ered by the program. The deleterious effects of limiting or withdrawing care to Medicaid patients has been described in a number of reports.6-8 Despite such reports, New York State has implemented a number of constraints on services to their Medicaid patients. Initially proposed in 1990, the restrictions were delayed by litigation. The program was finally implemented relatively quickly in the early fall of 1991. The essence of the regulations is that patients have limitations on physician visits, pharmaceutical services, dental encounters, and laboratory services during the 12-month period designated for each patient. We will refer to these limits as "caps." Medicaid requires that prescriptions be written for a 1-month supply, so that patients are required to renew chronic prescriptions monthly. Thus, a prescription written with five refills will translate into six "prescription services" for the following 6 months. If a patient requires more than the services allowed, a physician may complete a form requesting an increase in the limits. The form requires written justification for the increases. This study attempts to quantify the additional burden placed on the system to care for Medicaid patients in New York State. |
