HB23-1130 Summary

• Defines "serious mental illness" to include bipolar disorders, depression in childhood and adolescence, major depressive disorders, obsessive-compulsive disorders, paranoid and psychotic disorders, schizoaffective disorders, and schizophrenia, based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

• Limits step therapy requirements for prescription drugs prescribed for serious mental illness to only one alternative drug before coverage must be provided, unless a provider attests that clinical criteria are met.

• Exempts prescribed mental illness drugs from step therapy requirements when a provider attests that specific clinical criteria established by the Division are satisfied.

• Requires the state board to review and make coverage decisions for new FDA-approved drugs for serious mental illness within 90 days of approval.

• Appropriates $53,117 for fiscal year 2023-24 to the Department of Health Care Policy and Financing ($49,242 for personal services and $3,875 for operating expenses), with matching anticipated federal funds.