The Kansas Dept. of Health and Environment will soon convene an advisory committee to create recommendations for managing behavioral health medications in Medicaid. The committee is created by HB 2149, signed by Governor Brownback on May 15. The conference committee report also includes other Medicaid policy provisions. Read a description of the bill here.
HB 2149 was originally a bill to provide for Medicaid coverage of donor breast milk. The Senate added the provisions of SB 181 - creating an expedited process for newly introduced prescription medications. The Senate also inserted a new plan for instituting management of mental health medications in Medicaid through a specialized advisory committee. This advisory committee was proposed after SB 123 was defeated by the Senate. Senators agreed with advocates that SB 123 went too far by deleting the statutes that exempt mental health medications from prior authorizations or other drug management restrictions.
The bill allows prior authorization or other restrictions on medications used to treat mental illness to be imposed on Medicaid recipients for medications subject to guidelines developed by the Board in accordance with provisions of the bill; establishes instances not to be construed as restrictions; provides for the development of guidelines; establishes requirements for Board review of medications used to treat mental illness available for use before and after July 1, 2015; and creates a Mental Health Medication Advisory Committee (Committee), outlining Committee membership and appointments, meeting frequency, and member compensation.
Advocates view the new provisions as a better option than SB 123 - which would have simply deleted the statutory exemption from Medicaid management for MH drugs. SB 123 was defeated by the Senate. Read more about this issue.
The section of the bill regarding approval of new prescription medications (SB 181) amends the procedures regarding restrictions of patients’ access to any new prescription-only drug under the Kansas Medicaid Program and would establish meeting requirements for the Medicaid Drug Utilization Review Board (Board).
