Bill > H1182

This bill requires the Massachusetts Medicaid (MassHealth) program and its contracted health insurers, plans, and organizations to establish a step therapy program for prescription medications used to treat epilepsy and seizure disorders. The program may require patients to try and fail on one other medication before the prescribed medication is approved, but prescribers must have access to a clear process to request an override of this requirement. The division or its agents must grant an override if the prescriber demonstrates certain criteria, such as the preferred medication being ineffective or causing harm to the patient. The step therapy requirement is limited to 30 days, after which the prescriber's recommended medication must be dispensed and covered.

Health and Social Services

https://malegislature.gov/Bills/193/H1182