Bill Caption

Relating to the availability of antipsychotic prescription drugs under the vendor drug program and Medicaid managed care. 

Fiscal Notes

The fiscal implication of the bill are expected to increase the cost of providing antipsychotic medications to adults enrolled in Medicaid, but the exact fiscal impact cannot be determined at this time because the shift between preferred and non-preferred medications is unknown. 

Bill Analysis

HB 2822 would allow patients in the Medicaid Managed Care Program to get antipsychotic drugs that are nonpreferred to manage their mental health issue if preferred drugs do not work, the patient has been previously prescribed the nonpreferred antipsychotic drug, or the dosage limits are modified subject to federal law or Health and Human Services Commission rules. 

HB 2822 would not affect the authority of a pharmacist to: dispense the generic equivalent or interchangeable biological product of a prescription drug; review requirements by state or federal law; or clinical prior authorization edits to preferred and nonpreferred antipsychotic drug prescriptions.

HB 2822 would require the Executive Commissioner, in writing the rules and standards, to: require automation of clinical prior authorization for each drug, and ensure that pharmacists are immediately provided a clear point-of-sale return message to dispense a 72 hour supply of the prescription.

Vote Recommendation Notes

Texas Action supports HB 2822 which would benefit limited government by improving efficiency within Medicaid managed care for affected participants.