SB1420 HD1

Report Title:

Medicaid; Psychotropic Medication, Presumptive Eligibility

Description:

Prohibits DHS from restricting payment for or a recipient's access to psychotropic medication, requires DHS to establish presumptive eligibility for psychotropic medication coverage until a decision is made, and exempts licensed providers from preauthorization for prescription psychotropic medication. Establishes a task force to further study the issue of removing the restrictions on licensed medical physicians for prescribing psychotropic drugs to their patients. (SB1420 SD2 HD1)

THE SENATE	S.B. NO.	1420
TWENTY-THIRD LEGISLATURE, 2005		S.D. 2
STATE OF HAWAII		H.D. 1

A BILL FOR AN ACT

relating to psychotropic medication.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Chapter 346, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows:

"§346- Psychotropic medication. (a) The department shall not impose any restriction or limitation on the payment for or a recipient's access to psychotropic medication; provided that the psychotropic medication shall be prescribed by a licensed medical care provider pursuant to the laws of this State.

(b) As used in this section:

"Licensed medical care provider" means any medical professional licensed in Hawaii to prescribe psychotropic medications.

"Psychotropic medication" means only those agents related to the diagnosis and treatment of mental or emotional disorders, including controlled substances.

§346- Presumptive eligibility for medical assistance; individuals in need of emergency psychiatric or psychological service. (a) An individual who is in need of emergency psychiatric or psychological service and who has not received an eligibility decision from the department shall be presumed eligible for psychotropic medication until an eligibility decision is made; provided that the psychotropic medication shall be prescribed by a licensed medical care provider pursuant to the laws of this State. The department shall reimburse any costs associated with the medication and concomitant physician services during the presumptive eligibility period.

(b) As used in this section:

"Licensed medical care provider" means any medical professional licensed in Hawaii to prescribe psychotropic medications.

"Psychotropic medication" means only those agents related to the diagnosis and treatment of mental or emotional disorders, including controlled substances.

§346- Pre-authorization exemption for psychotropic medication. (a) A licensed medical care provider may prescribe psychotropic medication pursuant to the laws of this State to an individual who is medicaid eligible or who is presumed to be medicaid eligible without the requirement of any preauthorization procedure otherwise required by any other provision of this chapter; provided that the individual is in need of emergency psychiatric or psychological service.

(b) As used in this section:

"Licensed medical care provider" means any medical professional licensed in Hawaii to prescribe psychotropic medications.

"Psychotropic medication" means only those agents related to the diagnosis and treatment of mental or emotional disorders, including controlled substances."

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2005-2006 and the same sum or so much thereof as may be necessary for fiscal year 2006-2007 to provide unrestricted payment for and access to psychotropic medication for recipients under chapter 346, Hawaii Revised Statutes.

The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 3. (a) There is established a task force on psychotropic medication restrictions, which shall be placed in the department of human services for administrative purposes.

The task force shall:

(1) Study individuals with dual-eligible status in regards to the medicaid fee-for-service program, taking into consideration the medicaid Medication Act becoming effective on January 1, 2006, and any impact the task force may feel could occur if restrictions are removed from licensed medical physicians who prescribe psychotropic drugs;

(2) Examine the possibility of placing limits on licensed medical physicians who are not specifically trained in the treatment of mental and emotional disorders and their ability to prescribe psychotropic drugs;

(3) Study abuse, consumer addiction, and black marketing of psychotropic drugs;

(4) Review psychotropic regulatory methods used by current Hawaii health maintenance organizations; and

(5) Propose solutions for funding this initiative and providing an effective plan for the proper use of our pharmaceutical resources.

(b) The task force shall be composed of the following eight members:

(1) The director of human services or the director's designee;

(2) The director of health or the director's designee;

(3) The director of commerce and consumer affairs or the director's designee;

(4) The executive director of the Mental Health Association in Hawaii or the executive director's designee;

(5) The executive director of the National Alliance for the Mentally Ill-Oahu or the executive director's designee;

(6) The president of the Hawaii Disability Rights Center or the president's designee;

(7) The executive director of the Hawaii Psychiatric Medical Association or the executive director's designee; and

(8) An independent consumer of psychotropic medications.

(d) The members of the task force shall receive no compensation, but shall be reimbursed for travel and other necessary expenses incurred in the performance of their duties.

(e) The task force shall be convened before July 1, 2005. The business of the task force shall be to prepare a report, including proposed legislation, to the legislature no later than twenty days before the convening of the regular session of 2006. The task force shall cease to exist on June 30, 2008.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2006.