HB 1628 Summary

• Medicaid Drug Utilization Review Board must consider input from physicians, pharmacists, patients, and pharmaceutical manufacturers when placing drugs on prior authorization.

• Drugs placed on prior authorization must be reconsidered within 12 months and receive telephone or fax approval/denial within 24 hours of request.

• Emergency situations must receive a 72-hour supply or greater amount ensuring minimum effective therapy duration without waiting for prior authorization approval.

• Authority must develop written cost-savings estimates before expanding product-based prior authorization, presented to the board across a four-meeting sequence including public comment periods.

• HIV/AIDS drugs determined medically necessary and FDA-approved may be covered without prior authorization, except when generic equivalents are available.