Bill > SB5577

This bill requires the Washington State Health Care Authority to provide Medicaid coverage for all FDA-approved HIV antiviral drugs without prior authorization or step therapy requirements, ensuring that both fee-for-service and managed care Apple Health clients receive comprehensive access to these medications. Specifically, the bill mandates that managed health care systems contracted to administer Medicaid managed care plans must also provide coverage for these HIV antiviral drugs without imposing prior authorization or step therapy restrictions. The bill was originally set to take effect on July 1, 2025, but the governor vetoed Section 2 of the bill (the effective date section) while approving the rest of the legislation, noting that the funding for these medications was already included in the Health Care Authority's base expenditures. The primary goal of this legislation is to ensure that Medicaid recipients in Washington State have immediate and unrestricted access to HIV antiviral medications, potentially improving treatment outcomes and patient care for individuals living with HIV.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5577&Year=2025&Initiative=false