Human services: medical services; exemption of certain prescription drugs for the treatment or management of pain from the medical assistance prior authorization process; provide for. Amends sec. 109h of 1939 PA 280 (MCL 400.109h) & adds sec. 109v.
Impact
If enacted, SB 551 would amend existing regulations governing prescription medication coverage under the state's medical assistance program. It mandates that the Department of Health and Human Services ensures that non-opioid pain management medications are included in the preferred drug list. The goal is to prevent discrimination against these medications in favor of opioid alternatives, facilitating easier access for patients suffering from various conditions that require pain management. This legislative change aims to address the rising concerns over opioid dependence and promote safer alternatives.
Summary
Senate Bill 551 seeks to amend the Social Welfare Act, particularly section 109h, regarding the authorization process for prescription drugs covered under the medical assistance program in Michigan. The bill is focused on enhancing access to certain prescription medications by exempting specific non-opioid drugs prescribed for pain management from the prior authorization requirement. This change is intended to streamline the prescription process for patients who require pain relief without resorting to opioid analgesics.
Contention
The bill may face contention from various stakeholders, particularly in how it balances patient access to necessary medications with the need for oversight and regulation of pharmaceuticals. Some may argue that loosening prior authorization could lead to over-prescription or misuse of certain drugs, while proponents emphasize the need to provide safer pain management options in a healthcare landscape increasingly wary of opioids. The bill highlights the ongoing discussions regarding the opioid crisis and the legislative approach to manage pain treatment effectively.
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; 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; Medicaid coverage for fertility preservation; provide for. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109p.
Human services: medical services; general changes to the medical assistance program; provide for. Amends secs. 105b & 109f of 1939 PA 280 (MCL 400.105b & 400.109f) & repeals secs. 105c & 105f of 1939 PA 280 (MCL 400.105c & 400.105f).
Human services: medical services; coverage for cranial hair prosthesis; provide for under certain circumstances. Amends sec. 109 of 1939 PA 280 (MCL 400.109).
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).
Human services: medical services; medical assistance coverage for ultrasound procedures and fetal nonstress tests performed in certain locations; provide for. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding secs. 109q & 109r.
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; 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; exemption of certain prescription drugs from the medical assistance prior authorization process; provide for. Amends sec. 109h of 1939 PA 280 (MCL 400.109h).
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.
Manufacturers required to report and maintain prescription drug prices, filing of health plan prescription drug formularies required, health care coverage provisions modified, prescription benefit tool requirements established, and prescription drug benefit transparency and disclosure required.