OH HB250

Requires Medicaid providers to obtain prior authorization before dispensing opioid-containing controlled substances in non-cancer/terminal conditions exceeding a 10-day supply, for chronic pain patients exceeding 80 morphine equivalent dose milligrams per day, or for emergency department patients exceeding 72-hour supplies.

Establishes mandatory disapproval criteria for opioid prior authorization requests including recipient history of prescription fraud, drug misuse, accidental overdose, abuse/threats toward providers, or positive illicit substance screening.

Prohibits Medicaid managed care organizations from requiring prior authorization for antidepressant and antipsychotic medications in standard tablet/capsule form prescribed by credentialed psychiatrists.

Requires managed care organizations to implement pharmacy utilization management programs reviewing high-risk medication regimens (recipients prescribed both opioids and benzodiazepines within 12 months) and coordinated services programs for medically unnecessary drug procurement.

Adds definitions for "business day," "chronic pain," "morphine equivalent dose," and "nursing facility" to the Medicaid code.