This bill amends several sections of the Florida Statutes to enhance protocols for step-therapy concerning Medicaid recipients diagnosed with serious mental illnesses. It introduces a definition for "serious mental illness" in section 409.901, encompassing various psychiatric disorders recognized by the American Psychiatric Association. The bill mandates that the Agency for Health Care Administration (AHCA) must approve drug products for treating serious mental illnesses without requiring step-therapy prior authorization under specific circumstances, thereby facilitating quicker access to essential medications. Additionally, it modifies section 409.912 to emphasize the implementation of a Medicaid prescribed-drug spending-control program and outlines criteria for enrolling recipients in a drug benefit management program, aiming to improve oversight of prescription drug use.

Moreover, the bill establishes a return and reuse program for prescription drugs dispensed to institutional recipients, which includes a $5 restocking fee to minimize the destruction of unused medications. It requires the agency to post prior authorization criteria and updates on its website within 21 days of approval and introduces a step-therapy prior authorization process for non-preferred medications, necessitating prescribers to justify alternative medication use. The language in the bill shifts from "shall" to "must" in several instances, reinforcing the agency's obligations. The provisions of this act are set to take effect on October 1, 2025, with certain sections becoming effective immediately upon passage.

Statutes affected:
S 264 Filed: 409.912, 409.910