Senate Bill 83 aims to amend the Medical Assistance program by prohibiting the Department of Health Services (DHS) from implementing any utilization management controls on antipsychotic prescription drugs that have been approved by the federal Food and Drug Administration (FDA). Utilization management controls are techniques used to assess the medical necessity and appropriateness of prescription drugs, which can include prior authorization and step therapy protocols. The bill seeks to ensure that individuals receiving Medical Assistance, particularly those requiring antipsychotic medications, have better access to these essential treatments without the barriers typically imposed by utilization management practices.
The new legal language introduced in the bill defines "prescription drug" and "utilization management controls" and explicitly states that the DHS cannot impose such controls on FDA-approved antipsychotic medications. This legislative change is intended to enhance the accessibility of necessary medications for individuals with limited financial resources who rely on the Medical Assistance program for their healthcare needs.