SB 986 Summary

• Removes requirement for prior authorization of certain central nervous system prescription drugs including anticonvulsants, antidepressants, antipsychotics, and noncontrolled antianxiety drugs under the medical assistance program.

• Exempts from prior authorization requirement prescription drugs cross-indicated for the exempted central nervous system drugs and drugs recognized as effective for mental health conditions listed in the Diagnostic and Statistical Manual of Mental Disorders.

• Prohibits denial of prior authorization for controlled substances unless the department determines the substance or dosage is inconsistent with licensed indications or generally accepted medical practice.

• Exempts from prior authorization requirement prescription drugs recognized for treatment of HIV/AIDS, cancer, organ replacement therapy, and epilepsy or seizure disorder.

• Allows the department to exclude exempt drugs from its preferred drug list and clarifies the section does not apply to drugs provided through health maintenance organization contracts.