Human services: medical services; exemption of certain prescription drugs for the treatment or management of pain from the medical assistance prior authorization process; provide for. Amends sec. 109h of 1939 PA 280 (MCL 400.109h) & adds sec. 109v.
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill modifies Michigan’s Medicaid program to reduce barriers to accessing certain prescription drugs used to treat pain. Specifically, it exempts certain central nervous system drugs, drugs cross-indicated for pain medications, and drugs recognized for treating conditions like cancer, organ replacement, epilepsy, opioid withdrawal, and HIV/AIDS from prior authorization requirements. Additionally, it creates a new provision (Section 109v) to ensure coverage for non-opioid pain medications on the preferred drug list.
Key provisions
- Exempts specific prescription drugs (CNS, cross-indicated, and those treating certain conditions) from prior authorization.
- Creates Section 109v to provide coverage for non-opioid pain medications.
- Requires the Department of Health and Human Services to add a non-opioid pain medication to the preferred drug list within 90 days of the bill’s effective date.
- Prohibits the department from unduly disadvantaging non-opioid pain medications on the preferred drug list compared to opioid analgesics.
- Allows for reviews of potential medications for the preferred drug list, but prohibits these reviews from delaying or denying coverage.
- Defines key terms related to prescription drugs and prior authorization.
Who is affected
- Medicaid beneficiaries
- Prescribers
- Pharmaceutical manufacturers
- Managed care organizations
- The Michigan Department of Health and Human Services
Bill text
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- Senate Introduced Bill
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