| 3 | 2 | | *ANS120* 03-30-2023 11:25:01 ANS120 |
|---|
| 4 | 3 | | |
|---|
| 5 | 4 | | State of Arkansas As Engrossed: H3/16/23 H3/30/23 1 |
|---|
| 6 | 5 | | 94th General Assembly A Bill 2 |
|---|
| 7 | 6 | | Regular Session, 2023 HOUSE BILL 1276 3 |
|---|
| 8 | 7 | | 4 |
|---|
| 9 | 8 | | By: Representative L. Johnson 5 |
|---|
| 10 | 9 | | By: Senator J. Boyd 6 |
|---|
| 11 | 10 | | 7 |
|---|
| 12 | 11 | | For An Act To Be Entitled 8 |
|---|
| 13 | 12 | | AN ACT TO EXCLUDE AN TIPSYCHOTIC PRESCRIP TION DRUGS 9 |
|---|
| 14 | 13 | | FROM STEP THERAPY; A ND FOR OTHER PURPOSE S. 10 |
|---|
| 15 | 14 | | 11 |
|---|
| 16 | 15 | | 12 |
|---|
| 17 | 16 | | Subtitle 13 |
|---|
| 18 | 17 | | TO EXCLUDE ANTIPSYCHOTIC PRESCRIPTION 14 |
|---|
| 19 | 18 | | DRUGS FROM STEP THERAPY. 15 |
|---|
| 20 | 19 | | 16 |
|---|
| 21 | 20 | | 17 |
|---|
| 22 | 21 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 18 |
|---|
| 23 | 22 | | 19 |
|---|
| 24 | 23 | | SECTION 1. Arkansas Code § 23 -99-1114 is amended to read as follows: 20 |
|---|
| 25 | 24 | | 23-99-1114. Limitation on step therapy — Definition Definitions. 21 |
|---|
| 26 | 25 | | (a) An insurance policy that provides coverage for the treatment of 22 |
|---|
| 27 | 26 | | metastatic cancer shall not limit or exclude coverage under the health 23 |
|---|
| 28 | 27 | | benefit plan for a drug approved by the United States Food and Drug 24 |
|---|
| 29 | 28 | | Administration that is on the prescription drug formulary of the insurance 25 |
|---|
| 30 | 29 | | policy by mandating that a covered person with metastatic cancer undergo step 26 |
|---|
| 31 | 30 | | therapy if the insurance policy provides coverage for the treatment of: 27 |
|---|
| 32 | 31 | | (1) Psychosis and serious mental illness through 28 |
|---|
| 33 | 32 | | antipsychotic prescription drugs; and 29 |
|---|
| 34 | 33 | | (2) Metastatic cancer unless the preferred drug is 30 |
|---|
| 35 | 34 | | consistent with best practices that: 31 |
|---|
| 36 | 35 | | (1)(A) Are used for the treatment of metastatic cancer or 32 |
|---|
| 37 | 36 | | associated conditions under: 33 |
|---|
| 38 | 37 | | (A)(i) The United States Food and Drug 34 |
|---|
| 39 | 38 | | Administration-approved indication; or 35 |
|---|
| 40 | 39 | | (B)(ii) The National Comprehensive Cancer Network 36 As Engrossed: H3/16/23 H3/30/23 HB1276 |
|---|
| 41 | 40 | | |
|---|
| 42 | 41 | | 2 03-30-2023 11:25:01 ANS120 |
|---|
| 43 | 42 | | |
|---|
| 44 | 43 | | |
|---|
| 45 | 44 | | Drugs and Biologics Compendium indication; or 1 |
|---|
| 46 | 45 | | (2)(B) Use evidence-based, peer-reviewed, recognized 2 |
|---|
| 47 | 46 | | medical literature. 3 |
|---|
| 48 | 47 | | (b) As used in subsection (a) of this section,: 4 |
|---|
| 49 | 48 | | (1) “metastatic "Metastatic cancer” means cancer that has spread 5 |
|---|
| 50 | 49 | | from a primary or original site of the cancer to surrounding or nearby 6 |
|---|
| 51 | 50 | | tissues, lymph nodes, or other parts of the body ; 7 |
|---|
| 52 | 51 | | (2)(A) "Psychosis" means a condition that affects the mind and 8 |
|---|
| 53 | 52 | | affects the way the brain processes info rmation. 9 |
|---|
| 54 | 53 | | (B) "Psychosis" includes delusions and hallucinations; and 10 |
|---|
| 55 | 54 | | (3) "Serious mental illness" means a mental, behavioral, or 11 |
|---|
| 56 | 55 | | emotional disorder resulting in serious functional impairment, that 12 |
|---|
| 57 | 56 | | substantially interferes with or limits one (1) or mo re major life 13 |
|---|
| 58 | 57 | | activities. 14 |
|---|
| 59 | 58 | | (c) For psychosis and serious mental illness, if there is a generic 15 |
|---|
| 60 | 59 | | drug equivalent approved by the United States Food and Drug Administration 16 |
|---|
| 61 | 60 | | under the same chemical or generic name of a name brand drug that is 17 |
|---|
| 62 | 61 | | available, it is not considered step therapy to allow access to and coverage 18 |
|---|
| 63 | 62 | | for both the generic drug and the name brand drug. 19 |
|---|
| 64 | 63 | | 20 |
|---|
| 65 | 64 | | /s/L. Johnson 21 |
|---|
| 66 | 65 | | 22 |
|---|
| 67 | 66 | | 23 |
|---|