Wisconsin Senate Bill SB618

Wisconsin 2023-2024 Regular Session

• Introduced: 11/7/23
• Refer: 11/7/23
• Failed: 4/15/24

Caption

Utilization management controls for prescription drugs to treat mental illness under the Medical Assistance program. (FE)

Impact

The implementation of SB618 is intended to reduce barriers that patients encounter while trying to access essential medications for serious mental illnesses. By removing utilization management controls that can delay or obstruct access, the bill seeks to ensure that individuals with serious mental disorders such as bipolar disorder, schizophrenia, and major depressive disorder receive timely treatment. This approach could lead to improved health outcomes and overall well-being for affected individuals, promoting better engagement in society and the workforce.

Summary

Senate Bill 618 introduces significant changes aimed at mental health care, specifically concerning the utilization management controls for prescription drugs approved for treating serious mental illnesses under the Medical Assistance program. The bill prohibits the Department of Health Services from imposing any utilization management controls on prescription drugs that are FDA-approved for such treatments. This includes restrictions like prior authorization and step therapy protocols, aligning with the objective to enhance accessibility and ease of obtaining necessary medications for individuals facing serious mental health challenges.

Contention

Despite the perceived benefits, there may be contention surrounding SB618 as it addresses the balance between ensuring easy access to mental health medications and managing prescription drug utilization. Critics may argue that loosening controls could lead to increased costs or misuse within the Medical Assistance program, fueling concerns regarding the health care system's sustainability. Additionally, stakeholders in the pharmaceutical and insurance industries could express apprehension over the potential impacts on their operations and profitability, raising questions about regulatory adjustments and their long-term viability.