Bill > S0070

This bill focuses on step-therapy protocols for Medicaid recipients, specifically addressing mental health medication prescriptions. The bill first defines "serious mental illness" by listing specific psychiatric disorders from the Diagnostic and Statistical Manual of Mental Disorders, including conditions like bipolar disorders, major depressive disorders, schizophrenia, and others. It requires the Agency for Health Care Administration to modify its drug approval process, mandating that drug products for treating serious mental illness must be approved without step-therapy prior authorization under certain circumstances. The bill allows physicians to obtain approval for a specific medication if they can provide documentation that alternative medications have been ineffective, the patient has previously been granted prior authorization for the drug, or other clinically justified reasons. Additionally, the bill directs the agency to incorporate the financial impact of these changes into Medicaid managed care rates effective October 1, 2026. The primary goal is to streamline the medication approval process for patients with serious mental illnesses, potentially reducing barriers to accessing appropriate psychiatric medications and ensuring more personalized treatment approaches.

https://www.flsenate.gov/Session/Bill/2026/70