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AZ SB1395
Bill
Status
1/26/2022
Primary Sponsor
Thomas Shope
Click for details
AI Summary
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Requires health care services plans to cover prescribed drugs for treating serious mental illness without prior authorization if the drug is a covered benefit, medically necessary, does not exceed FDA-recommended dosages, and the prescriber performs annual reviews of efficacy and health status.
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Defines "serious mental illness" as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders that results in serious functional impairment and substantially interferes with one or more major life activities.
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Applies the prior authorization exemption to both private health care services plans under section 20-3402 and Arizona Health Care Cost Containment System (AHCCCS) covered medications under section 36-2907.
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Prohibits step therapy, prior authorization requirements, and other protocols that could restrict or delay dispensing of mental health medications meeting the specified conditions.
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Maintains existing requirement that health care services plans provide at least one modality of medication-assisted treatment without prior authorization.
Legislative Description
Mental health medication; prior authorization
Exceptions
Last Action
Senate read second time
1/27/2022