OH SB387

Requires Ohio Medicaid managed care organizations to cover pharmacogenomic testing (genetic testing to evaluate how a patient's genetics affect drug efficacy, safety, or toxicity) when deemed medically necessary for enrollees diagnosed with depression or anxiety.

Testing qualifies as medically necessary when ordered by a treating prescriber who is considering a medication change, dose adjustment, or augmentation for drugs with known gene-drug interactions, and the test is covered under Medicare's local coverage determination.

Permits managed care organizations to impose prior authorization requirements, but mandates a clear pathway to coverage, minimum documentation requirements, and a 30-day authorization window following specimen collection.

Authorizes the Department of Medicaid to fine noncompliant managed care organizations up to $10,000 per violation plus $1,000 per day for ongoing noncompliance, and may require corrective action plans within 30 days, withhold payments, reduce capitation rates, or terminate contracts.

Requires the Department of Medicaid to establish a reporting process for enrollees, prescribers, and laboratories to report instances of noncompliance, separate from existing grievance procedures.