Texas House Bill HB3732

Texas 2017 - 85th Regular

Caption

Relating to prescription drug benefits under the Medicaid program.

Impact

The legislation would amend the Texas Government Code to streamline the prior authorization process for medications, ensuring that patients can obtain necessary medications without unnecessary delays. In particular, it emphasizes the authority of the Drug Utilization Review Board to evaluate and suggest restrictions on prescription drugs effectively. By emphasizing patient needs in its processes, the bill aims to enhance patient safety and treatment efficacy while providing clarity for healthcare providers regarding compliance with Medicaid regulations.

Summary

House Bill 3732 addresses prescription drug benefits under the Medicaid program, aiming to improve access to necessary medications for recipients. A significant feature of the bill is the requirement that newly enrolled patients in Medicaid or related health programs receive continuity of care, which means they will not have to undergo prior authorization for a medication they have previously been prescribed for up to one year. This provision seeks to reduce barriers to medication access during a critical transition period for patients newly entering these programs.

Contention

While proponents of HB 3732 argue that the bill enhances patient care by minimizing delays in medication access, there are concerns about the implications for clinical decision-making. Opponents worry that stipulating certain protocols may inadvertently limit the discretion of healthcare providers in tailoring treatments to individual patient needs. Additionally, the necessity for state-level procedures for step therapy protocols could complicate the process. Advocates for this approach maintain that all recommendations from the Drug Utilization Review Board must be based on sound clinical evidence, thus, hoping to alleviate concerns regarding the quality of care.