FL H0183

Defines "serious mental illness" in Florida Medicaid law to include bipolar disorders, depression in childhood or adolescence, major depressive disorders, obsessive-compulsive disorders, paranoid personality disorder or other psychotic disorders, schizoaffective disorders, and schizophrenia, as classified by the DSM-5.

Requires the Agency for Health Care Administration (AHCA) to approve drug products for the treatment of serious mental illness without step-therapy prior authorization when the prescribing physician provides written medical or clinical documentation of medical necessity.

Expands the existing step-therapy exemption for drugs treating schizophrenia or schizotypal/delusional disorders to cover all defined serious mental illnesses, allowing patients previously authorized and dispensed such medications within the prior 12 months to continue without step-therapy requirements.

Directs AHCA to incorporate the rate impact of the act into Medicaid managed medical assistance and long-term care managed care program rates effective October 1, 2023.

Effective date is October 1, 2023.