The bill amends Minnesota Statutes 2024, section 256B.0625, subdivision 13f, to expand the prior authorization requirements for mental health medications. It introduces new language that allows for prior authorization or other utilization management controls for central nervous system prescription drugs classified as anticonvulsants, antidepressants, antipsychotics, or noncontrolled substance antianxiety drugs. The bill also specifies that prior authorization must be granted automatically for 60 days for brand-name drugs prescribed for mental illness when a generically equivalent drug becomes available, provided the brand-name drug was part of the recipient's treatment at that time.

Additionally, the bill defines "utilization management controls" as formal techniques used to monitor prescription drug use and evaluate their medical necessity and efficacy. It establishes a streamlined prior authorization process for patients who utilize enteral tubes for medication administration, ensuring that these patients can receive necessary medications without undue delay. The bill also includes provisions for the commissioner to require prior authorization for brand-name drugs even when a generically equivalent product is available, regardless of specific instructions from the prescriber.

Statutes affected:
Introduction: 256B.0625