FL S0268

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

Requires the Agency for Health Care Administration to approve drug products for treating serious mental illness without step-therapy prior authorization when a prescribing physician provides written documentation of medical necessity

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

Directs the Agency for Health Care Administration to incorporate the rate impacts of the act into Medicaid managed medical assistance and long-term care managed care program rates effective October 1, 2024

Sets an effective date of October 1, 2024