The bill aims to revise preauthorization laws by directing the Department of Public Health and Human Services to eliminate the requirement for prior authorization for certain antipsychotic drugs under the Medicaid program. Specifically, the bill states that the department may not require prior authorization for any antipsychotic drug approved by the U.S. Food and Drug Administration for its approved indications for Medicaid members aged 18 and older. This change is intended to remove barriers to timely treatment for serious mental illnesses.
Additionally, the bill clarifies that it does not mandate the department to cover antipsychotic drugs that are not eligible for coverage under federal law. The bill includes provisions for its effective date, which is set to be 30 days after passage and approval, and specifies that it applies to claims submitted for payment for services provided on or after the effective date. The previous legal language regarding the department's authority and the criteria for drug approval has been deleted and replaced with the new provisions.