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. (SD1)

THE SENATE

S.B. NO.

1420

TWENTY-THIRD LEGISLATURE, 2005

S.D. 1

STATE OF HAWAII

 


 

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, the term "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, the term "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 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, the term "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.

SECTION 3. The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2005.