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 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 also establishes a streamlined prior authorization process for patients who require oral liquid forms of drugs and utilize enteral tubes for feeding or medication administration. The bill ensures that prior authorization is not required for any class of drugs approved by the FDA for the treatment or prevention of HIV and AIDS, thereby enhancing access to necessary medications for individuals with mental health needs.

Statutes affected:
Introduction: 256B.0625