It’s Fail First Again

Just when you think we’ve gotten over it, “fail first” policy pops up again. In this case, the North Carolina Department of Health and Human Services, Division of Medical Assistance (DMA) has announced a new “fail first” policy for antipsychotic medications (see North Carolina Medicaid Implements Fail-First Policy For Non-Preferred Antipsychotic Medications). If you’re not familiar with the concept, essentially a consumer of health care must “fail” on a "preferred" (meaning less costly drug) in order to get payment for a different medication. In this case, as of January 1, 2015, consumers in the North Carolina . . .