California 2023-2024 Regular Session

California Assembly Bill AB1437 Compare Versions

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1-Enrolled September 14, 2023 Passed IN Senate September 12, 2023 Passed IN Assembly May 25, 2023 Amended IN Assembly April 13, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1437Introduced by Assembly Members Irwin and Quirk-SilvaFebruary 17, 2023An act to add Section 14133.19 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1437, Irwin. Medi-Cal: serious mental illness.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.Under this bill, a prescription refill for a drug for serious mental illness would automatically be approved for a period of 365 days after the initial prescription is dispensed.The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
1+Amended IN Assembly April 13, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1437Introduced by Assembly Members Irwin and Quirk-SilvaFebruary 17, 2023An act to add Section 14133.19 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1437, as amended, Irwin. Medi-Cal: serious mental illness.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.Under this bill, a treatment authorization request would not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness, as defined. Under the bill, a prescription refill for a drug for serious mental illness would automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:14133.19.(a)Notwithstanding any other law, subject to subdivision (c), a treatment authorization request shall not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness.(b)14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.(c)Subdivisions (a) and (b) shall apply(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(d)(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
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3- Enrolled September 14, 2023 Passed IN Senate September 12, 2023 Passed IN Assembly May 25, 2023 Amended IN Assembly April 13, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1437Introduced by Assembly Members Irwin and Quirk-SilvaFebruary 17, 2023An act to add Section 14133.19 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1437, Irwin. Medi-Cal: serious mental illness.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.Under this bill, a prescription refill for a drug for serious mental illness would automatically be approved for a period of 365 days after the initial prescription is dispensed.The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
3+ Amended IN Assembly April 13, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1437Introduced by Assembly Members Irwin and Quirk-SilvaFebruary 17, 2023An act to add Section 14133.19 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1437, as amended, Irwin. Medi-Cal: serious mental illness.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.Under this bill, a treatment authorization request would not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness, as defined. Under the bill, a prescription refill for a drug for serious mental illness would automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
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5- Enrolled September 14, 2023 Passed IN Senate September 12, 2023 Passed IN Assembly May 25, 2023 Amended IN Assembly April 13, 2023
5+ Amended IN Assembly April 13, 2023
66
7-Enrolled September 14, 2023
8-Passed IN Senate September 12, 2023
9-Passed IN Assembly May 25, 2023
107 Amended IN Assembly April 13, 2023
118
129 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
1310
1411 Assembly Bill
1512
1613 No. 1437
1714
1815 Introduced by Assembly Members Irwin and Quirk-SilvaFebruary 17, 2023
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2017 Introduced by Assembly Members Irwin and Quirk-Silva
2118 February 17, 2023
2219
2320 An act to add Section 14133.19 to the Welfare and Institutions Code, relating to Medi-Cal.
2421
2522 LEGISLATIVE COUNSEL'S DIGEST
2623
2724 ## LEGISLATIVE COUNSEL'S DIGEST
2825
29-AB 1437, Irwin. Medi-Cal: serious mental illness.
26+AB 1437, as amended, Irwin. Medi-Cal: serious mental illness.
3027
31-Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.Under this bill, a prescription refill for a drug for serious mental illness would automatically be approved for a period of 365 days after the initial prescription is dispensed.The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.
28+Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.Under this bill, a treatment authorization request would not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness, as defined. Under the bill, a prescription refill for a drug for serious mental illness would automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.
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3330 Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
3431
3532 Existing law sets forth a schedule of benefits under the Medi-Cal program, including specialty and nonspecialty mental health services through different delivery systems, in certain cases subject to utilization controls, such as prior authorization. Under existing law, prior authorization is approval of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law sets forth various provisions relating to processing, or appealing the decision of, treatment authorization requests, and provisions relating to certain services requiring or not requiring a treatment authorization request.
3633
3734 After a determination of cost benefit, existing law requires the Director of Health Care Services to modify or eliminate the requirement of prior authorization as a control for treatment, supplies, or equipment that costs less than $100, except for prescribed drugs, as specified.
3835
39-Under this bill, a prescription refill for a drug for serious mental illness would automatically be approved for a period of 365 days after the initial prescription is dispensed.
36+Under this bill, a treatment authorization request would not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness, as defined. Under the bill, a prescription refill for a drug for serious mental illness would automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.
4037
4138 The bill would condition the above-described provisions on the prescription being for a person 18 years of age or over, and on the person not being within the transition jurisdiction of the juvenile court, as specified.
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4340 ## Digest Key
4441
4542 ## Bill Text
4643
47-The people of the State of California do enact as follows:SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
44+The people of the State of California do enact as follows:SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:14133.19.(a)Notwithstanding any other law, subject to subdivision (c), a treatment authorization request shall not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness.(b)14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.(c)Subdivisions (a) and (b) shall apply(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(d)(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
4845
4946 The people of the State of California do enact as follows:
5047
5148 ## The people of the State of California do enact as follows:
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53-SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
50+SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:14133.19.(a)Notwithstanding any other law, subject to subdivision (c), a treatment authorization request shall not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness.(b)14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.(c)Subdivisions (a) and (b) shall apply(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(d)(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
5451
5552 SECTION 1. Section 14133.19 is added to the Welfare and Institutions Code, to read:
5653
5754 ### SECTION 1.
5855
59-14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
60-
61-14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
62-
63-14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
56+14133.19.(a)Notwithstanding any other law, subject to subdivision (c), a treatment authorization request shall not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness.(b)14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.(c)Subdivisions (a) and (b) shall apply(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(d)(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
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6558
6659
67-14133.19. (a) Notwithstanding any other law, subject to subdivision (b), a prescription refill for a drug for serious mental illness shall automatically be approved for a period of 365 days after the initial prescription is dispensed.
60+(a)Notwithstanding any other law, subject to subdivision (c), a treatment authorization request shall not be required for the provision of a prescription drug prescribed to prevent, assess, or treat a serious mental illness.
61+
62+
63+
64+(b)
65+
66+
67+
68+14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.(c)Subdivisions (a) and (b) shall apply(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(d)(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
69+
70+14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.(c)Subdivisions (a) and (b) shall apply(b) Subdivision (a) applies only if both of the following conditions are met:(1) The prescription is for a person 18 years of age or over.(2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.(d)(c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.(2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).
71+
72+
73+
74+14133.19. (a) Notwithstanding any other law, subject to subdivision (c), (b), a prescription refill for a drug for serious mental illness shall automatically be approved if the department verifies a record of a paid claim that documents a diagnosis of a serious mental illness within 365 days before the date of that prescription. for a period of 365 days after the initial prescription is dispensed.
75+
76+(c)Subdivisions (a) and (b) shall apply
77+
78+
6879
6980 (b) Subdivision (a) applies only if both of the following conditions are met:
7081
7182 (1) The prescription is for a person 18 years of age or over.
7283
7384 (2) The person is not within the transition jurisdiction of the juvenile court, as described in Section 450.
85+
86+(d)
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88+
7489
7590 (c) (1) For purposes of this section, serious mental illness means a mental disorder that is identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and that is severe in degree and persistent in duration, presents a major risk to the persons health and well-being, causes behavioral functioning that interferes substantially with the primary activities of daily living, and results in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.
7691
7792 (2) Serious mental illness may include, but is not limited to, schizophrenia, post-traumatic stress disorder, bipolar disorder, other major affective disorders, or other severely disabling mental disorders pursuant to paragraph (1).