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House Co-Sponsorship Memoranda
House of Representatives
Session of 2013 - 2014
Regular Session
MEMORANDUM
| Posted: | March 4, 2013 02:15 PM |
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| From: | Representative Bryan Cutler and Rep. Jake Wheatley, Jr. |
| To: | All House members |
| Subject: | RE-RUN of Psychiatric Exemption-(Former HB 1317) |
| ** This co-sponsorship had been circulated as two pieces of legislation, however after speaking to stakeholders and the Senate, we've decided to run this as one piece. Listed below are the members who had originally signed on to each separate piece of legislation previously circulated. Should you wish to co-sponsor the attached legislation as one piece, please add yourself in the system** We will be introducing legislation that provide licensed psychiatrists an exemption from prior authorization for drugs they prescribe for Medicaid fee-for-service patients. These bills will also require the Department of Public Welfare to include behavioral health drugs in their electronic pharmacy adjudication system for Medicaid fee-for-service patients. This system is currently operating, but does not include behavior drug classes, a situation that can result in delays for patients in receiving their behavioral drugs. This legislation was HB 1317 of last session. It passed the House by a vote of 123 to 72 and was referred to Senate Public Health and Welfare in November. The Medicaid fee-for-service program currently requires prior authorization for many behavior health drugs. While this makes sense in terms of providing capability for the DPW to control inappropriate prescribing, very little inappropriate prescribing (and resulting costs) is generated by licensed psychiatrists. Psychiatrists tend to treat the more severally ill mental health patients and prior authorization can act as a barrier to care for these vulnerable patients. Prior authorization would remain in place for non-psychiatrists. We believe that this is a very targeted approach to the issue of assuring access to treatment for vulnerable behavioral health patients. Ohio recently implemented a similar exemption administratively and many states exempt, by statute, entire behavioral drug classes from prior authorization. In fact, a recent study by the research arm of the American Psychiatric Association showed a significant difference in the percentage of psychiatrists reporting access problems in Medicaid between states with prior authorization and those with exemptions. In Pennsylvania, 61.2% of psychiatrists reported their patients having difficulty accessing prescribed medications. By contrast, in New York where mental health medications are statutorily protected from prior authorization, only 27.1% of psychiatrists reported having medication access problems. The study also found that patients with medication access problems were 3.6 times more likely to have adverse events including emergency room visits, psychiatric hospitalization, homelessness and incarceration. All of these events are likely more expensive to the Commonwealth than the cost of the medications being restricted. CO-SPONSORS OF ELECTRONIC APPROVAL PORTION: Kortz, Harkings, Baker, Hennessey, Hickernell, Kirkland, Cohen, Brown, Heffley, Costa, Hess, Gingrich, Quinn, Molchany, Davidson, Fabrizio, Murt, Clymer, Watson CO-SPONSORS OF PSYCHIATRIC DRUG EXEMPTION PORTION: Kortz, Harkins, Baker, Hennessey, Hickernell, Cohen, Brown, Costa, Hess, Gingrich, Molchany, Davidson, Murt, Clymer, Watson |
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| View Attachment | ||
Introduced as HB1287