Title: Medi-Cal: serious mental illness: drugs.
Author: Jacqui V. Irwin
AB 1178, as amended, Irwin.
Medi-Cal: serious mental illness: drugs.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to qualified low-income persons pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, the provision of prescription drugs is a Medi-Cal benefit, subject to the list of contract drugs and utilization controls. After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs.This bill would delete the prior authorization requirement for any drug prescribed for the treatment of a serious mental
illness, as defined, for a period of 180 days after the initial prescription has been dispensed for a person over 18 years of age who is not under the transition jurisdiction of the juvenile court. The bill would require the department to automatically approve a prescription for a drug for the treatment of a serious mental illness if that drug was previously dispensed to the patient, as specified, and certain conditions are met, including that the
patient is not under the transition jurisdiction of the juvenile court. The bill would require the department to authorize a pharmacist to dispense a 90-day supply of a drug prescribed for the treatment of a serious mental illness if that prescription drug is included in the Medi-Cal list of contract drugs and the prescription otherwise conforms to applicable formulary requirements, including that the patient has filled at least a 30-day supply for the same prescription in the previous 90 days, and to dispense an early refill prescribed for the treatment of a serious mental illness if that prescription drug is included in the Medi-Cal list of contract drugs and the prescription otherwise conforms to prescribed standards, such as limiting the number of refills to no more than 3 in a calendar year.
Read first time. To print. 02/18/2021
From printer. May be heard in committee March 21. 02/19/2021
Referred to Com. on HEALTH. 03/04/2021
From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (April 20). 04/27/2021
Read second time and amended. 04/28/2021
Re-referred to Com. on APPR. 04/29/2021
In committee: Set, first hearing. Referred to APPR. suspense file. 05/12/2021
In committee: Held under submission. 05/20/2021
Died pursuant to Art. IV, Sec. 10(a) of the Constitution. 01/31/2022
From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. 02/01/2022
AB 1178 - Amended+Assembly
04/28/2021 - AB 1178 (Amended+Assembly)
AB 1178 - Introduced
02/18/2021 - AB 1178 (Introduced)