Bill > SB2201

This bill amends the Government Code to add a new Subchapter C related to prescription drug benefits under certain outpatient pharmacy benefit plans implemented by Medicaid managed care organizations. The key provisions include: 1) defining "step therapy protocol" as a requirement to use a certain drug or sequence of drugs before coverage is provided for the physician's recommended drug; 2) requiring Medicaid managed care organizations to establish a process for providers to submit step therapy protocol exception requests; 3) specifying the grounds under which the organization must grant an exception request; and 4) requiring organizations to post their preferred drug lists and maintain a searchable database of preferred drugs and restrictions. The bill also allows for delayed implementation if a federal waiver or authorization is needed.