Citations Affected: IC 12-7-2-51.8 ; IC 12-15-26-3.
Synopsis: Mental health drugs for Medicaid recipients. Provides that
a recipient in the fee for service Medicaid program may not be
restricted access to mental health drugs.
Effective: Upon passage.
January 14, 2002, read first time and referred to Committee on Health and Provider
A BILL FOR AN ACT to amend the Indiana Code concerning
described in subsection (d).
(d) A prescription drug, including a brand name drug that has a generically equivalent drug product (as defined by IC 16-42-22-4 ), that is prescribed for a Medicaid recipient's mental illness, as classified in the most recent publication of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, is not subject to prior authorization if the drug is one (1) of the following:
(1) A central nervous system drug:
(A) classified as an antianxiety, antidepressant, or antipsychotic drug; or
(B) that after January 1, 2002, is classified in a new category or classification;
in the most recent publication of Drug Facts and Comparisons (published by J.B. Lippincott Company).
(2) A cross-indicated drug used as an antianxiety, antidepressant, or antipsychotic drug according to the American Psychiatric Press Textbook of Psychopharmacy, Current Clinical Strategies for Psychiatry, Drug Fact and Comparisons, or a publication with a similar focus and content.
(e) The office may place limits on quantities dispensed or the frequency of refills for a drug listed under this section only if the office:
(1) adopts the limits on quantities and refills for the purpose of preventing fraud, abuse, waste, overutilization, or inappropriate utilization, or to implement disease management;
(2) takes into account quality of care and the best interests of Medicaid recipients;
(3) seeks the advice of the drug utilization review board (established by IC 12-15-35) at a public meeting; and
(4) publishes and distributes a provider bulletin that complies with the requirements of IC 12-15-13-6.