Senate File 565 - Introduced SENATE FILE 565 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO SSB 1231) A BILL FOR An Act relating to prior authorization for medication-assisted 1 treatment under the Medicaid program. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2667SV (2) 88 pf/rh
S.F. 565 Section 1. MEDICATION-ASSISTED TREATMENT —— MEDICAID —— 1 PRIOR AUTHORIZATION. 2 1. The department of human services shall adopt rules 3 pursuant to chapter 17A to require that under both Medicaid 4 fee-for-service and managed care administration, at least one 5 form of medication-assisted treatment approved by the United 6 States food and drug administration for treatment of substance 7 use disorder, in each of the following categories, is available 8 to Medicaid members without prior authorization: 9 a. Methadone. 10 b. Buprenorphine. 11 c. Naloxone. 12 d. Buprenorphine and naloxone combination. 13 e. Naltrexone. 14 2. For the purpose of this section, “medication-assisted 15 treatment” means the medically monitored use of certain 16 substance use disorder medications in combination with 17 treatment services. 18 EXPLANATION 19 The inclusion of this explanation does not constitute agreement with 20 the explanation’s substance by the members of the general assembly. 21 This bill requires the department of human services 22 to adopt administrative rules to require that under both 23 Medicaid fee-for-service and managed care administration, 24 at least one form of medication-assisted treatment in 25 specified categories shall be available to Medicaid members 26 without prior authorization. For the purpose of the bill, 27 “medication-assisted treatment” means the medically monitored 28 use of certain substance use disorder medications in 29 combination with treatment services. 30 -1- LSB 2667SV (2) 88 pf/rh 1/ 1