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Bill to remove 'fail‑first' prior authorization for some antipsychotics draws medical, agency debate
Summary
House Bill 610 would eliminate prior authorization requirements for antipsychotic drugs for Medicaid fee‑for‑service beneficiaries with serious mental illness. Supporters argued delays harm patients and raise long‑term costs; DPHHS cautioned the change could raise drug spending and offered a different fiscal calculation.
Representative (sponsor) introduced House Bill 610 to remove prior authorization requirements that the sponsor and proponents described as "fail‑first" policies for antipsychotic medications used to treat schizophrenia and bipolar disorder. Supporters, including pharmaceutical company Alkermes, clinicians and national mental‑health organizations, said prior authorization causes harmful delays and abandonment of treatment. They cited surveys of physicians saying prior authorization often delays care and can lead to treatment abandonment, and noted…
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