Objective: To examine rates of potentially inappropriate prescribing in a population dually eligible for Medicare and Medicaid using the new 2003 Fick update. The 2003 Fick update revises the previous 1997 Beers list – an internationally recognized list of drugs identified as potentially inappropriate to prescribe to seniors due to an elevated risk of adverse effects, developed by Dr. Mark Beers. Methods: Descriptive analyses (population parameter assessments) were conducted on the 2003 Medicaid files for elderly enrollees dually eligible for Medicare and Medicaid. Inappropriate drugs independent of diagnosis as identified by the 2003 Fick update were analyzed. Results: Our enrollee population was comprised of 5,412,678 enrollees (71% female, 41% age 65-74, 66% Caucasian) with 24% receiving an inappropriate drug per the 1997 Beers list; 34% per the 2003 Fick update. Across all census regions, Hispanic enrollees received the highest percentage of inappropriate drugs per the 2003 Fick update. Of enrollees with drug use (3,879,039 enrollees), 34% received an inappropriate drug per the 1997 Beers list; 47% per the 2003 Fick update. Hispanics had the highest percentage of drug recipients receiving an inappropriate drug in the Northeast region per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20% (the drug Nitrofurantoin prescribed most) per the 2003 Fick update. Conclusion: Based on the 2003 Fick update, 47% of elderly dually eligible Medicare and Medicaid drug recipients received inappropriate drugs. However, such use may be justified in some circumstances when the benefits outweigh the risks for an individual patient. Our findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups. By comparing drug use based on therapeutic category, genitourinary products were found to have the highest potential for inappropriate prescribing.