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Avoiding Pharmageddon: Helping Patients Stay on their Medications Through their Transitions November 20, 2013 Kathleen Clanon, MD Sophy Wong, MD Tjost.

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Presentation on theme: "Avoiding Pharmageddon: Helping Patients Stay on their Medications Through their Transitions November 20, 2013 Kathleen Clanon, MD Sophy Wong, MD Tjost."— Presentation transcript:

1 Avoiding Pharmageddon: Helping Patients Stay on their Medications Through their Transitions November 20, 2013 Kathleen Clanon, MD Sophy Wong, MD Tjost at Woot!

2 2 Raise Hand Mute Chat

3 At the conclusion of today’s session, please use the following URL LINK to complete your participant evaluation form: 3 We will also the link to you as well. https://aetcnec.virtualforum.com/pefidform.cfm?erid =24997&sc=533834&aetccode=12

4 Avoiding Pharmageddon: Helping Patients Stay on their Medications Through their Transitions November 20, 2013 Kathleen Clanon, MD Sophy Wong, MD Tjost at Woot!

5 Objectives Strategies Pharmageddon

6 What is still unclear?

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8 Bad Medi-Cal letter

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10 Legal immigrants <5 years and <138% FPL …are now are eligible to enroll in state-funded Medi-Cal!

11 Legal immigrants <5 years and <138% FPL …What’s going to happen to Maria? -In US since Makes $10k/year

12 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).

13 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

14 Pharmageddon Tjost at Woot!

15 Pharmageddon

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20 Avoiding HPAC to Medi-Cal transitions 1.Timely authorizations 2.Emergency 72 hour supply 3.Non-formulary drug stabilization 4.Carve-out for mental health and substance abuse medications Pharmageddon

21 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

22 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!

23 What is your plan?

24 Questions? Comments?

25 East Bay AIDS Education & Training Center Sophy Wong, MD, Medical Director Shailey Merchant Klinedinst, MPH, Program Manager Gracie Askew, Training Manager (510) phone (510) fax 25

26 Please use the following URL to complete your participant evaluation form: 26 We will also the link directly to you as well. Thanks ! https://aetcnec.virtualforum.com/pefidform.cfm?erid =24997&sc=533834&aetccode=12


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