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Cuts Could Leave Mentally Ill Patients Without Needed Drugs

Doctors Say State's Plan To Cut Medicaid Costs Is Backfiring

POSTED: 4:49 p.m. EDT October 20, 2003
UPDATED: 5:31 p.m. EDT October 20, 2003

The state's cutbacks in Medicaid coverage, aimed to save money, is backfiring, according to doctors, and patients unable to continue their regular drug regimes fear the consequences.

NewsCenter 5's Jorge Quiroga reported that thousands of Massachusetts residents recently learned state cutbacks would keep them from getting the drugs they need through Mass Health, the state's insurance program for the poor.

Among them are many with mental illnesses, who say they're being hurt the most while the state is saving little money. Joanne McNeil was diagnosed as bipolar, a psychiatric disorder she controls by taking Neurontin pills twice a day. But without the pills, she said, she is always nervous.

"Crazy, wild, hyper, always shaking the leg, just always nervous," said McNeil.

Medicaid cutbacks have left McNeil counting the days until her prescription runs out.

To reign in pharmacy costs, MassHealth(space or not? need to be consistent throughout) has restricted medications like Neurontin and other drugs that are not officially designated for psychiatric purposes.

Kathleen Puglisi is also bipolar and her prescription was also denied. She's tried other drugs, but nothing has worked. Now that she is off Neurontin, she said she feels miserable and fears a relapse.

"I wouldn't even go to the mailbox, didn't want to answer the phone, wouldn't answer the door, unless I had somebody with me at all times. Very scared, very paranoid," said Puglisi.

Dr. George Sigel, a psychiatrist, said cutbacks have caused serious injury to many poor, mentally ill patients like Puglisi.

"They are second guessing the doctor-patient relationship," said Sigel. Sigel is suing the state.

"Let me work it out with my patients. And if it's working, don't disrupt it," said Sigel.

Bowing to public pressure, the state recently restored cuts to some psychiatric drugs for the poor. Officials at the Division of Medical Assistance declined to be interviewed for this report but sent a copy of their policy stating prescriptions are "reviewed by a licensed pharmacist to determine if the drug is medically necessary."

"We see many patients here that are extremely depressed, suicidal, psychotic," said Massachusetts General Hospital emergency room physician Dr. Lawrence Parks.

If cutting costs is the state's goal, doctors argue the policy is backfiring.

"People come in to the emergency rooms not having got the meds they need and eventually needing inpatient hospitalization which, in the long run, costs a lot more," said Parks.

McNeil said her problems are beyond her control and her choices are simply pay now or pay later.

"If I stop, I'll be like the old Joanne -- hyper all over again. And I can't even think what would happen if I stopped taking them," said McNeil.

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