The bill amends the Social Welfare Act by modifying section 109h and adding a new section 109v. It establishes that if the Department of Health and Human Services creates a prior authorization process for prescription drugs under the medical assistance program, it cannot require prior authorization for certain categories of drugs. These include specific central nervous system prescription drugs, drugs cross-indicated for those, and drugs recognized for treating various conditions such as cancer, epilepsy, and HIV. Additionally, the bill introduces section 109v, which mandates that the department provide coverage for non-opioid analgesic drugs prescribed for pain management, ensuring these drugs are not disadvantaged compared to opioid analgesics on the preferred drug list.

Furthermore, the bill outlines that within 90 days of its enactment, the department must add qualifying non-opioid drugs to the preferred drug list and ensure that they are not subject to more restrictive utilization review measures than those applied to opioid analgesics. It also clarifies that the department can still maintain a preferred drug list that favors certain drugs, as long as it does not create an unfair disadvantage for non-opioid pain management drugs. The bill aims to enhance access to essential medications while ensuring that patients have appropriate options for pain management without unnecessary barriers.

Statutes affected:
Senate Introduced Bill: 400.109