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 methods like prior authorization and step therapy protocols. This bill seeks to ensure that individuals receiving Medical Assistance, particularly those requiring antipsychotic medications, have better access to necessary treatments without the barriers typically imposed by utilization management.
The bill introduces a new section, 49.45 (9o), which defines "prescription drug" and "utilization management controls" while explicitly stating that the DHS cannot impose such controls on FDA-approved antipsychotic medications. This legislative change is intended to enhance the availability of essential mental health medications for individuals with limited financial resources, thereby improving their overall health outcomes.