HF 623 (LSB 2547HV (2) 88)

HOUSE FILE 623

BY  COMMITTEE ON HUMAN RESOURCES

(SUCCESSOR TO HSB 200)

A BILL FOR

An Act relating to prior authorization for medication-assisted treatment under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICATION-ASSISTED TREATMENT —— MEDICAID —— PRIOR AUTHORIZATION.
   1.  The department of human services shall adopt rules pursuant to chapter 17A to require that under both Medicaid fee-for-service and managed care administration, at least one form of medication-assisted treatment approved by the United States food and drug administration for treatment of substance use disorder, in each of the following categories, is available to Medicaid members without prior authorization:
   a.  Methadone.
   b.  Buprenorphine.
   c.  Naloxone.
   d.  Buprenorphine and naloxone combination.
   e.  Naltrexone.
   2.  For the purpose of this section, “medication-assisted treatment” means the medically monitored use of certain substance use disorder medications in combination with treatment services.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill requires the department of human services to adopt administrative rules to require that under both Medicaid fee-for-service and managed care administration, at least one form of medication-assisted treatment in specified categories shall be available to Medicaid members without prior authorization. For the purpose of the bill, “medication-assisted treatment” means the medically monitored use of certain substance use disorder medications in combination with treatment services.