Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB654 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	LRB-4976/1
2	2	JPC:skw&amn
3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 654
5	5	November 9, 2023 - Introduced by Representatives NOVAK, DITTRICH and DONOVAN,
6	6	cosponsored by Senators JAMES, BALLWEG, CABRAL-GUEVARA and QUINN.
7	7	Referred to Committee on Health, Aging and Long-Term Care.
8	8	*AUTHORS SUBJECT TO CHANGE*
9	9	AN ACT to create 49.45 (9o) of the statutes; relating to: utilization management
10	10	controls for prescription drugs to treat mental illness under the Medical
11	11	Assistance program.
12	12	Analysis by the Legislative Reference Bureau
13	13	This bill prohibits the Department of Health Services from imposing any
14	14	utilization management controls for prescription drugs under the Medical
15	15	Assistance program that are approved by the federal Food and Drug Administration
16	16	and have an indication of approval from the federal Food and Drug Administration
17	17	for the treatment of a serious mental illness. Under the bill, “serious mental illness”
18	18	is defined to mean a mental disorder, as defined in the most recent edition of the
19	19	Diagnostic and Statistical Manual of Mental Disorders published by the American
20	20	Psychiatric Association, such as bipolar disorder, schizophrenia or schizotypal
21	21	disorder, major depressive disorder, or post-traumatic stress disorder, that results
22	22	in serious functional impairment that substantially interferes with or limits one or
23	23	more major life activities. Currently, DHS administers the Medical Assistance
24	24	program, which is a joint federal and state program that provides health services to
25	25	individuals who have limited financial resources.
26	26	For further information see the state fiscal estimate, which will be printed as
27	27	an appendix to this bill.
28	28	The people of the state of Wisconsin, represented in senate and assembly, do
29	29	enact as follows:
30	30	1
31	31	2
32	32	3 - 2 -2023 - 2024 Legislature LRB-4976/1
33	33	JPC:skw&amn
34	34	SECTION 1 ASSEMBLY BILL 654
35	35	SECTION 1. 49.45 (9o) of the statutes is created to read:
36	36	49.45 (9o) UTILIZATION MANAGEMENT CONTROLS FOR PRESCRIPTION DRUGS TO TREAT
37	37	MENTAL ILLNESS. (a) In this subsection:
38	38	1. “Prescription drug” has the meaning given in s. 450.01 (20).
39	39	2. “Serious mental illness” means a mental disorder, as defined in the most
40	40	recent edition of the Diagnostic and Statistical Manual of Mental Disorders
41	41	published by the American Psychiatric Association, such as bipolar disorder,
42	42	schizophrenia or schizotypal disorder, major depressive disorder, or post-traumatic
43	43	stress disorder, that results in serious functional impairment that substantially
44	44	interferes with or limits one or more major life activities.
45	45	3. “Utilization management controls” means a set of formal techniques used by
46	46	a health carrier or prescription drug utilization management entity that are
47	47	designed to evaluate prescription drug medical necessity, appropriateness, efficacy,
48	48	or efficiency, including prior authorization and step therapy protocols.
49	49	(b) The department may not impose utilization management controls for any
50	50	prescription drug that is approved by the federal food and drug administration and
51	51	has an indication of approval from the federal food and drug administration for the
52	52	treatment of a serious mental illness.
53	53	(END)
54	54	1
55	55	2
56	56	3
57	57	4
58	58	5
59	59	6
60	60	7
61	61	8
62	62	9
63	63	10
64	64	11
65	65	12
66	66	13
67	67	14
68	68	15
69	69	16
70	70	17
71	71	18
72	72	19