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Senate committee advances substitute to cut prior authorization for some serious mental-illness drugs
Summary
A committee substitute to exempt certain medications for people defined as having serious mental illness from prior authorization was presented, debated and moved out of committee after a procedural motion that approved a tax/transportation committee substitute. Supporters said it would improve continuity of care; insurers warned of safety and fiscal risks.
A Senate committee on Feb. 13 considered a committee substitute for Senate Bill 20 that would narrow prior-authorization requirements for medications prescribed to people the bill defines as having a serious mental illness. Sponsor remarks, expert testimony and public comment centered on whether easing prior authorization would improve medication continuity for people with schizophrenia and other persistent conditions or instead reduce clinical oversight and raise costs.
Sponsor presentation and key provisions
Sponsor Senator Stefanos presented the committee substitute as a targeted exception to prior authorization for drugs treating serious mental illness. The bill inserts a standardized definition for “serious mental illness” (drawing on CDC/DSM-5 and SAMHSA language), expands references to pharmacy-benefit managers and the interagency purchasing collaborative (IBAC), requires insurers to deem a prescription prior-authorization granted if the…
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