House Bill 721 amends the Florida Statutes to improve the prior authorization process for medications within the Medicaid program, particularly for recipients diagnosed with serious mental illnesses. The bill defines "serious mental illness" according to the American Psychiatric Association's standards and mandates that the Agency for Health Care Administration (AHCA) approve certain drug products for these patients without requiring step-therapy prior authorization if adequate medical documentation is provided. The bill also emphasizes the need for cost-effective purchasing and quality care, introducing a Medicaid prescribed-drug spending-control program that includes a preferred drug list and a behavioral drug management system to enhance medication adherence and prescribing practices.

Additionally, the bill establishes a return and reuse program for medications dispensed to institutional recipients, which includes a $5 restocking fee to facilitate the program's implementation. This initiative aims to minimize the waste of unused Medicaid prescription drugs by allowing pharmacies to return and reuse specific medications. The AHCA is tasked with evaluating the program's effectiveness and its implications for Medicaid rates, which will be updated to reflect the changes introduced by this act, effective October 1, 2025. Overall, the bill seeks to streamline access to necessary medications while ensuring fiscal responsibility within the Medicaid program.

Statutes affected:
H 721 Filed: 409.912, 409.910