Medicaid is a joint federal – state health insurance program that assists those persons with low income and limited resources. In New York State, the State government requires county governments to administer and provide Medicaid services and to pay a portion of the cost of Medicaid.
Medicaid became law in 1965. It is often confused with Medicare. Medicare is a federal health insurance program that helps the elderly and disabled. It is possible to qualify for both programs. In that case, Medicaid typically pays the Medicare coinsurance and deductibles. Medicaid has a core of services mandated by the Federal government and optional services the states can cover or provide if they so choose. New York State covers nearly all the optional services for Medicaid.
Medicaid services can be provided in one of three ways – Fee for Service, Rate, and Managed Care. Fee for Service is a process where Medicaid providers are paid a fee for the service provided. The fee is based upon a set maximum price for units of service. Rate providers are paid a threshold rate based upon cost report data submitted annually to the New York State Department of Health. There are other reimbursement formulas for Rate providers and the rate can vary daily, monthly or annually. In Managed Care, Managed Care Organizations (“MCO”) are paid a monthly capitation payment for each enrolled member to coordinate the provision, quality and cost of care for these enrolled members.
Below are some key Medicaid data points for selected years and ending with 2019. More detail on Medicaid, Medicaid expenditures within Erie County and Erie County Medicaid recipients can be found in the 2018 Medicaid Report generated by this office. See the section maked "Latest News".
The Medicaid Drugs in Erie County with the Most Filled Prescriptions are:
|1||Ibuprofen||Atorvastatin Calcium||Atorvastatin Calcium||Atorvastatin Calcium|
|5||Lisinopril||Metformin HCL||Ventolin HFA||Omeprazole|
|6||Metformin HCL||Ventolin HFA||Gabapentin||Metformin HCL|
|7||Ventolin HFA||Hydrocodone-Acetaminophen||Metformin HCL||Amlodipine Besylate|
|8||Amlodipine Besylate||Amlodipine Besylate||Amlodipine Besylate||Levothyroxine Sodium|
|9||Levothyroxine Sodium||Gabapentin||Levothyroxine Sodium||Albuterol Sulfate|
|11||Amoxicillin||Amoxicillin||Vitamin D||Vitamin D|
|12||Aspirin||Vitamin D||Sertraline HCL||Sertraline HCL|
|All Prescriptions Filled||3,190,990||3,278,086||3,250,151||1,681,172|
|Just Above Scripts Filled||676,377||667,229||668,071||335,584|
|Percent of Total||21.20%||20.35%||20.56%||19.96%|
A 2019 data covers the period January 1, 2019 through June 30, 2019 and is not final.
|Drug Name||Commonly prescribed for:|
|Amlodipine Besylate||High blood pressure treatment|
|Amoxicillin||Infection treatment (Antibiotic)|
|Aspirin||Over the counter pain reliever|
|Atorvastatin Calcium||Elevated cholesterol treatment|
|Clonazepam||Epilepsy treatment and treatment for bipolar disease and panic attacks|
|Gabapentin||Anti-epileptic medication and treatment for some kinds of nerve pain|
|Hydrochlorothiazide||Treatment for high blood pressure, also osteoporosis and is a diuretic|
|Hydrocodone-Acetaminophen||Treatment for moderate to severe pain|
|Ibuprofen||Over the counter pain reliever|
|Levothyroxine Sodium||Treatment for thyroid deficiency|
|Lisinopril||High blood pressure treatment|
|Loratadine||Treatment for allergies|
|Metformin HCL||Treatment for type two diabetes or pre-diabetics|
|Omeprazole||Treatment for acid reflux|
|Ventolin HFA||Treatment for asthma or allergies|
|Vitamin D||Addresses bone loss and cognitive impairment|