Critics fear Kaine's cost-cutting drug plan may backfire

RICHMOND

A budget amendment proposed by Gov. Timothy M. Kaine to save the state $1.5 million by providing less expensive medications to some mental health patients has raised the hackles of some advocates and legislators.

Under Kaine's plan, state mental health patients covered by Medicaid would receive certain anti-depressant, anti-psychotic and anti-anxiety medications from a list of drugs that are less costly.

If those medications aren't effective, individual patients can apply to receive more expensive drugs.

A trial-and-error medicine regimen can have a negative effect on patients, mental health advocates said Friday at a news conference in the state Capitol.

"Virginia needs to keep their eye on the ball when it comes to what we're doing for our patients with mental illness," said Dr. Colleen Kraft, president of the state chapter of the American Academy of Pediatrics.

"The question is: Do we want our physicians spending their time caring for our patients... or do we want physicians fighting with insurance companies and Medicaid?" Kraft added.

Kaine's proposed amendment also drew responses from Sen. Edward Houck, D-Spotsylvania, and Del. Phillip Hamilton, R-Newport News.

Houck, a Kaine ally, noted that the immediate cost savings could be offset by long-term costs of hospital stays and jail time in some cases.

In a written statement, Hamilton said the proposal would take "a step backwards in providing a needed treatment option for those with some form of mental illness."

Officials in the Kaine administration say the proposal would not jeopardize the well-being of mental health patients on Medicaid.

"There's certainly no indication that there should be any deterioration of a person's status by these changes," said Dr. Jim Reinhard, commissioner of the state Department of Mental Health, Mental Retardation and Substance Abuse Services. Reinhard, a psychiatrist, is a member of a state committee that would review medications to be placed on the preferred drug list.

About 30,000 Virginians take the kinds of medications discussed in the budget amendment - it applies to about 100 different drugs - though few would have to switch, said Patrick Finnerty, director of the state Department of Medical Assistance Services.

Julian Walker, (804) 697-1564, julian.walker@pilotonline.com