Two Republican lawmakers have filed proposals that would allow Medicaid beneficiaries with “serious mental illness” to avoid a practice known as step therapy in receiving medications.
Rep. Karen Gonzalez Pittman, R-Tampa, filed the House version of the proposal (HB 491) on Thursday, after Sen. Gayle Harrell, R-Stuart, filed the Senate version (SB 268) last month. The identical bills are filed for consideration during the 2024 legislative session, which will start in January.
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Step therapy generally involves requiring a patient to try one type of medication to determine if it is effective before being able to try a more-expensive drug. The bills would allow Medicaid beneficiaries with conditions such as bipolar disorder, major depressive disorders and schizophrenia to be able to avoid step therapy if their physicians submit documentation about the medical necessity.
The Senate passed a bill during the 2023 legislative session that would have made such a change, but the issue did not pass the House.
Most Medicaid beneficiaries receive care through managed-care plans. The bills would direct the state Agency for Health Care Administration to include the effects of the proposed change in rates paid to managed-care plans.
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