Montana bill would bar Medicaid prior approval for certain antipsychotic drugs
If enacted, Montana’s health department could not require Medicaid members to get prior approval for certain antipsychotic drugs.
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What it does
If enacted, Montana’s health department could not require Medicaid prior approval for certain antipsychotic drugs used for conditions listed in the current diagnostic guide.
Argument forPeople who need these medicines could avoid waiting for Medicaid approval before getting treatment, if the bill takes effect.
Argument againstWithout prior approval, Medicaid may have fewer chances to check whether these prescriptions treat conditions listed in the drug guide.
More detail
If enacted, the health department could not require Medicaid prior approval for certain antipsychotic drugs. This covers antipsychotic drugs under Montana’s Medicaid program. The drug must be approved by the federal Food and Drug Administration and recognized in the latest edition of the American Psychiatric Association’s diagnostic guide as effective for a condition listed there. The bill would take effect 30 days after it is passed and approved. It would apply to payment claims for services provided on or after that date.
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