Human services: medical services; coverage for treatment of menopause and perimenopause symptoms and waiver of prior authorization for prescription drugs or treatments for menopause and perimenopause symptoms; require. Amends sec. 109h of 1939 PA 280 (MCL 400.109h) & adds sec. 109t.
Impact
The passage of HB4815 would make a significant impact on state laws concerning healthcare coverage, particularly regarding the treatment for menopause and perimenopause. By eliminating prior authorization for specific categories of prescription medications, including various central nervous system drugs and therapies for cancer and substance use disorders, the bill would streamline access to necessary medical care. This change is designed to enhance patient care and potentially reduce delays in treatment, ultimately providing individuals with timely access to medicines they need.
Summary
House Bill 4815 aims to amend the 1939 PA 280, commonly referred to as 'The Social Welfare Act,' specifically targeting the processes and criteria surrounding prescription drug authorizations within the medical assistance program in Michigan. This legislation introduces provisions that would waive prior authorization requirements for certain prescription drugs used to treat various medical conditions, including those relating to menopause and perimenopause. By ensuring that treatments for these conditions, such as hormone replacement therapy, are readily accessible without prior authorization, the bill seeks to improve the quality of care for individuals experiencing menopause symptoms.
Contention
While the bill presents numerous beneficial aspects, it is not without contention. Some stakeholders may express concerns regarding the potential implications of loosening prior authorization requirements, fearing it could lead to overprescription and potential misuse of certain medications. Conversely, advocates argue that the current authorization processes can be barriers that prevent timely access to critical medications. There may be pushback from entities focused on healthcare cost control and regulation, highlighting the need to balance accessibility with responsible prescribing practices.
Human services: medical services; Medicaid coverage for fertility preservation; provide for. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109p.
Human services: medical services; specialty integrated plan; provide for in behavioral health services. Amends sec. 105d & 109f of 1939 PA 280 (MCL 400.105d & 400.109f).
Human services: medical services; coverage for abortions; require. Amends secs. 108 & 109 of 1939 PA 280 (MCL 400.108 & 400.109). TIE BAR WITH: HB 4958'23
Human services: medical services; coverage for abortions; require. Amends secs. 108 & 109 of 1939 PA 280 (MCL 400.108 & 400.109). TIE BAR WITH: SB 0478'23
Human services: medical services; coverage for mental health screenings during postpartum period; require. Amends sec. 109 of 1939 PA 280 (MCL 400.109).
Human services: medical services; guidelines for coverage for perinatal and gynecological services; provide for. Amends sec. 109 of 1939 PA 280 (MCL 400.109). TIE BAR WITH: HB 5636'24
Human services: medical services; general changes to the medical assistance program; provide for. Amends secs. 105d & 106 of 1939 PA 280 (MCL 400.105d & 400.106) & repeals secs. 105c & 105f of 1939 PA 280 (MCL 400.105c & 400.105f).
Human services: medical services; coverage for pharmacogenomic testing; provide to eligible individuals under the social welfare act. Amends sec. 109 of 1939 PA 280 (MCL 400.109).
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.