SCS/SB 507 - This act establishes the "Ensuring Access to High Quality Care for the Treatment of Substance Use Disorders Act". These provisions specify that medication-assisted treatment (MAT) services shall include, but not be limited to, pharmacologic and behavioral therapies. Formularies used by a health insurer or managed by a pharmacy benefits manager, and medical benefit coverage in the case of medications dispensed through an opioid treatment program, shall include all certain specified medications. All MAT medications required for compliance with these provisions shall be placed on the lowest cost-sharing tier of the formulary. MAT services provided for under these provisions shall not be subject to: annual or lifetime dollar limits; limits to predesignated facilities, specific numbers of visits, days of coverage, days in a waiting period, scope or duration of treatment, or other similar limits; financial requirements and quantitative treatment limitations that do not comply with the federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA); step therapy or other similar strategies when it interferes with a prescribed or recommended course of treatment from a licensed health care professional; or prior authorization.
These provisions shall apply to all health insurance plans delivered in the state.
This act is identical to provisions in the truly agreed to and finally passed CCS/SS/SCS/HCS/HB 399 (2019), SS#2/HB 219 (2019), as amended, the truly agreed to and finally passed SB 514 (2019), HCS/SS/SCS/SBs 70 & 128 (2019), and SCS/HB 758 (2019) and similar to provisions in HCS/SB 275 (2019) and HCS/HB 904 (2019).
SARAH HASKINS