Legislature passes bill on mental-health prescriptions for Medicaid recipients

TOPEKA — A bill that critics say could restrict access to high quality drugs for mental health patients on Medicaid has been passed by the Kansas Legislature.

The bill would empower the state’s Drug Utilization Review Program Board to place restrictions on prescription drugs used to treat mental illness for Medicaid patients. Existing law prevents the state from restricting Medicaid patients’ access to medication for mental illness.

Under the change, Medicaid patients would not immediately qualify for premium drugs. The state estimates it could save $16 million next fiscal year by allowing the board to set requirements for patients in order to receive certain medications.

The board falls under the umbrella of the Kansas Department of Health and Environment, the agency that administers the state’s Medicaid program and helped craft the legislation.

The legislation, HB 2149, passed the House on a 82-31 vote Friday. It was approved by the Senate earlier in the week, 31-6. It now heads to the governor’s desk.

The bill would allow the use of the generic versions first with a possible switch to the name-brand version if an individual patient needs it. Sara Belfry, spokeswoman for the KDHE, said that in many cases a generic version of a drug works just as well as its name-brand equivalent.

Doctors would need to fill out more paperwork to authorize their patients for the name-brand drugs. Belfry said the legislation allows for an emergency fill of a three-day supply of a prescription if necessary to give the doctor time to complete the authorization paperwork.

The bill also sets up a mental health advisory committee to help guide decisions about which drugs work best.

Rep. Jim Ward, D-Wichita, said on the House floor that the restrictions would prevent mental health patients from receiving proper treatment, which could cause a string of adverse effects.

“More people are going to get in trouble with the law because of mental illness. More people are going to lose their home because they lose their job,” Ward said. “There’s going to be more people who are hospitalized because they’re mentally ill and they can’t treat their illness.”

“Because you can’t save $16 million without taking drugs from mentally ill people, you’re going to have a situation where we’re going to read in the paper about a mentally ill person doing something to harm people because of that illness,” Ward said.

Rep. Dan Hawkins, R-Wichita, who chairs the House Health Committee, said the bill gives the KDHE more oversight to ensure that medications are being prescribed and used properly.

He said the KDHE would operate under a principle of “do no harm” and would not risk taking patients off drugs that are effective.

“If a person is already on a certain mental health drug and they’re stable and everything’s working out for them, they are not going to take them off that drug,” Hawkins said. “For people coming on mental health drugs, they’re going to start them through essentially what’s a step therapy; they’ll start them at a lower level and they’ll move them up until they find out which one works. Instead of just immediately going to the most expensive drug, a lot of times there may be a less-expensive drug that has the same outcome and they’ll use that.”

Belfry said that the bill allows the KDHE to ensure that children in particular aren’t overprescribed mental health medications.

This story was originally published May 8, 2015 at 11:44 AM with the headline "Legislature passes bill on mental-health prescriptions for Medicaid recipients."