Georgia House Bill HB1179

Georgia 2023-2024 Regular Session

• Introduced: 2/7/24

Caption

Insurance; step therapy protocols may not be required for medications prescribed for the treatment of serious mental illness under health benefit plans; provide

Impact

The implementation of HB 1179 is expected to have a profound impact on state health laws, particularly in how mental health treatments are accessed. By eliminating step therapy for serious mental illnesses under both health benefit plans and Medicaid, the bill potentially improves patient outcomes by allowing for timely and effective treatment. Advocates believe this law will reduce the time patients spend on ineffective medications, thereby addressing mental health crises more efficiently and potentially reducing overall healthcare costs associated with untreated mental illness.

Summary

House Bill 1179 aims to amend the Official Code of Georgia to prohibit the use of step therapy protocols by health benefit plans for medications prescribed to treat serious mental illnesses. This legislation seeks to ensure that patients diagnosed with conditions like bipolar disorder, major depressive disorder, and schizophrenia receive immediate access to necessary medications without the burden of mandated step therapy, which often requires patients to try and fail on less effective drugs before accessing their prescribed therapies. This change is seen as a significant move to enhance the quality of care for individuals suffering from serious mental health conditions.

Contention

A notable point of contention surrounding HB 1179 relates to the financial implications for insurers and how this may change the dynamics of prescribing medications for mental health issues. Opponents of the bill might argue that such regulations could increase insurance costs and limit choices for patients due to restricted formularies. Therefore, the legislative debate is likely to highlight the balance between ensuring patient access to necessary medications and maintaining sustainable healthcare costs for insurers.