Two Republican lawmakers, Rep. Karen Gonzalez Pittman and Sen. Gayle Harrell, have introduced bills that seek to provide more accessible and effective medication to Medicaid beneficiaries with serious mental illness. The House version of the proposal, HB 491, was filed by Rep. Pittman while the Senate version, SB 268, was filed by Sen. Harrell. Both bills are set for consideration during the upcoming 2024 legislative session starting in January.
The proposed bills aim to address step therapy, a practice that requires patients to try a less expensive medication before moving on to a more costly one based on their effectiveness. Under these bills, Medicaid beneficiaries with conditions such as bipolar disorder, major depressive disorders, and schizophrenia would be able to skip step therapy if their physicians provide documentation of medical necessity.
During the previous legislative session in 2023, the Senate passed a bill that aimed to make this change but it did not pass the House. However, since most Medicaid beneficiaries receive care through managed-care plans, these bills would direct the state Agency for Health Care Administration to consider the effects of the proposed change in rates paid to managed-care plans.
Overall, these bills represent an important step towards ensuring that those with serious mental illness have access to effective medication that can help them manage their conditions and improve their quality of life.