This bill amends the "Benefit Determination and Utilization Review Act" and the "Medical Assistance" chapter of the General Laws. It introduces a new section that prohibits health insurers and pharmacy benefit managers from requiring or conducting prospective or concurrent reviews for certain prescription medications used in the treatment of alcohol or opioid use disorders. Specifically, this includes medications that contain methadone, buprenorphine, or naltrexone, as well as any medication that has been approved by the United States Food and Drug Administration for the management of alcohol or opioid use disorder or for the mitigation of opioid withdrawal symptoms.
Additionally, the bill mandates that Medicaid managed care organizations utilize the medical necessity criteria selected by the executive office of health and human services when conducting utilization reviews for Medicaid benefits. This act is designed to take effect upon passage.