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GA HR1254

Resolution

Status

Engrossed

3/22/2016

Primary Sponsor

Edward Stephens

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Origin

House of Representatives

2015-2016 Regular Session

AI Summary

  • Urges the Georgia Department of Community Health to require Medicaid care management organizations to provide full coverage for extended-release ADHD medications, including Vyvanse, and to add Vyvanse to preferred drug listings for Medicaid Managed Care patients
  • Responds to WellCare and its pharmacy benefit manager CareMark removing Vyvanse from its Preferred Drug Listing effective October 1, 2015, impacting more than 7,000 Georgia Medicaid patients who must now fail trials on two other preferred drugs before receiving approval
  • Estimates the removal of Vyvanse will result in an approximately $3,528,107 annual net loss to Georgia due to decreased federally mandated Medicaid drug rebates
  • Highlights coverage inconsistencies for patients transitioning from Fee-for-Service Medicaid (which covers Vyvanse) to Medicaid Managed Care, where WellCare's preferred drug list does not align with the state's Medicaid preferred drug list
  • Directs distribution of the resolution to the Commissioner of the Georgia Department of Community Health and to Medicaid care management organizations operating in Georgia

Legislative Description

Medicaid care management organizations; cover certain attention deficit hyperactivity disorder medications; encourage

Last Action

House Passed/Adopted

3/22/2016

Full Bill Text

No bill text available