Measure could cut Medicaid costs

A state senator looking to curb rising Medicaid costs hopes dollar signs can trump politics in the upcoming legislative session.

After several failed attempts over the past two years, Sen. Allen Christensen, R-North Ogden, has now taken the lead on an effort to establish a preferred drug list (PDL) for Utah's $1.6 billion Medicaid program. Christensen's bill, SB42, would make clear the state health department's authority to develop a list.

"We simply have to have the savings in the Medicaid program," he said.

PDL proponents argue the lists can provide millions of dollars a year in savings by creating a registry of drugs, usually older or generic formularies, that doctors can prescribe to Medicaid patients.

The idea is supported by Gov. Jon Huntsman Jr. and Dr. David Sundwall, executive director of the Utah Health Department, who estimates a PDL would save the state between $8 million and $10 million annually. Though the health department has never been expressly forbidden from establishing a PDL, Sundwall has been reticent because of many lawmakers' opposition to the idea.

The powerful Executive Appropriations Committee has twice rejected health department requests to establish a PDL, and Rep. Steve Mascaro, R-West Jordan, pulled a similar measure last year when it became clear it did not have legislative support.

Christensen, a pediatric dentist, said he has secured the support from several formerly outspoken PDL opponents and hopes the proposed cost savings will persuade others to support his bill.

"Its final and above-all purpose is to get the best drugs into the hands of our Medicaid families," he said. "And if we can get a cost savings at the same time, it's a win-win for everyone, except maybe the pharmaceutical companies."

Sundwall, who has repeatedly testified on Capitol Hill about the benefits of a PDL, said he is pleased that SB42 would finally — and statutorily — affirm the department's right to move forward with the program.

"It has been a dilemma for me to know whether or not we can do it, or should do it, without the approval of the Legislature," he said.

The Medicaid Interim Committee, of which Christensen is part, voted Friday to recommend that a 5 percent limitation be placed on Medicaid budget growth for the next year while more long-term program savings are researched and implemented.

"We have to get some savings in Medicaid someplace. We are going to have to hold the costs down or cut programs," he said. "That's the bottom line with this."