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2021 SESSION
SB 1269 Health insurance; authorization of drug prescribed for the treatment of a mental disorder.
Introduced by: Jeremy S. McPike | all patrons ... notes | add to my profiles
SUMMARY AS PASSED SENATE: (all summaries)
Health insurance; authorization of drug prescribed for the treatment of a mental disorder. Requires that any provider contract between a carrier and a participating health care provider with prescriptive authority, or its contracting agent, contain provisions that require, when a carrier has previously approved prior authorization for any drug prescribed for the treatment of a mental disorder listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, no additional prior authorization can be required if (i) the drug is a covered benefit, (ii) the prescription does not exceed the U.S. Food and Drug Administration-labeled dosages, (iii) the prescription has been continuously issued for no fewer than three months, and (iv) the prescriber performs an annual review of the patient to evaluate the drug's continued efficacy, changes in the patient's health status, and potential contraindications. The bill provides that this requirement does not prohibit a carrier from requiring prior authorization for any drug that is not listed on its prescription drug formulary at the time the initial prescription is issued. The bill also provides that such provider contracts contain provisions requiring a carrier to honor a prior authorization issued by the carrier for a drug regardless if the drug is removed from the carrier's prescription drug formulary after the initial prescription for that drug is issued. Under the bill, provisions related to provider contracts and prior authorization will apply to the state insurance health plan.
FULL TEXT
- 01/12/21 Senate: Prefiled and ordered printed; offered 01/13/21 21101311D pdf | impact statement
- 01/25/21 Senate: Committee substitute printed 21103534D-S1 pdf | impact statement
AMENDMENTS
HISTORY
- 01/12/21 Senate: Prefiled and ordered printed; offered 01/13/21 21101311D
- 01/12/21 Senate: Referred to Committee on Commerce and Labor
- 01/25/21 Senate: Reported from Commerce and Labor with substitute (15-Y 0-N)
- 01/25/21 Senate: Committee substitute printed 21103534D-S1
- 01/27/21 Senate: Constitutional reading dispensed (39-Y 0-N)
- 01/28/21 Senate: Read second time
- 01/28/21 Senate: Reading of substitute waived
- 01/28/21 Senate: Committee substitute agreed to 21103534D-S1
- 01/28/21 Senate: Engrossed by Senate - committee substitute SB1269S1
- 01/29/21 Senate: Read third time and passed Senate (37-Y 0-N)
- 02/02/21 House: Placed on Calendar
- 02/02/21 House: Read first time
- 02/02/21 House: Referred to Committee on Labor and Commerce
- 02/08/21 House: Continued to Special Session 1 in Labor and Commerce by voice vote