| 1 | 1 | | 2025 - 2026 LEGISLATURE |
|---|
| 2 | 2 | | LRB-0646/1 |
|---|
| 3 | 3 | | JPC:emw |
|---|
| 4 | 4 | | 2025 SENATE BILL 83 |
|---|
| 5 | 5 | | February 26, 2025 - Introduced by Senators JAMES, CABRAL-GUEVARA and |
|---|
| 6 | 6 | | WANGGAARD, cosponsored by Representatives NOVAK, GUNDRUM, B. |
|---|
| 7 | 7 | | JACOBSON, MURSAU, SORTWELL, STEFFEN and TITTL. Referred to Committee |
|---|
| 8 | 8 | | on Mental Health, Substance Abuse Prevention, Children and Families. |
|---|
| 9 | 9 | | AN ACT to create 49.45 (9o) of the statutes; relating to: utilization |
|---|
| 10 | 10 | | management controls for antipsychotic prescription drugs 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 are classified as antipsychotic. Utilization management controls are formal |
|---|
| 17 | 17 | | techniques used by a health carrier or prescription drug utilization management |
|---|
| 18 | 18 | | entity that are designed to evaluate prescription drug medical necessity, |
|---|
| 19 | 19 | | appropriateness, efficacy, or efficiency. Currently, DHS administers the Medical |
|---|
| 20 | 20 | | Assistance program, which is a joint federal and state program that provides health |
|---|
| 21 | 21 | | services to individuals who have limited financial resources. |
|---|
| 22 | 22 | | For further information see the state fiscal estimate, which will be printed as |
|---|
| 23 | 23 | | an appendix to this bill. |
|---|
| 24 | 24 | | The people of the state of Wisconsin, represented in senate and assembly, do |
|---|
| 25 | 25 | | enact as follows: |
|---|
| 26 | 26 | | 1 |
|---|
| 27 | 27 | | 2 |
|---|
| 28 | 28 | | 3 2025 - 2026 Legislature |
|---|
| 29 | 29 | | SENATE BILL 83 |
|---|
| 30 | 30 | | - 2 - LRB-0646/1 |
|---|
| 31 | 31 | | JPC:emw |
|---|
| 32 | 32 | | SECTION 1 |
|---|
| 33 | 33 | | SECTION 1. 49.45 (9o) of the statutes is created to read: |
|---|
| 34 | 34 | | 49.45 (9o) UTILIZATION MANAGEMENT CONTROLS FOR ANTIPSYCHOTIC |
|---|
| 35 | 35 | | PRESCRIPTION DRUGS. (a) In this subsection: |
|---|
| 36 | 36 | | 1. XPrescription drugY has the meaning given in s. 450.01 (20). |
|---|
| 37 | 37 | | 2. XUtilization management controlsY means a set of formal techniques used |
|---|
| 38 | 38 | | by a health carrier or prescription drug utilization management entity that are |
|---|
| 39 | 39 | | designed to evaluate prescription drug medical necessity, appropriateness, efficacy, |
|---|
| 40 | 40 | | or efficiency, including prior authorization and step therapy protocols. |
|---|
| 41 | 41 | | (b) The department may not impose utilization management controls for any |
|---|
| 42 | 42 | | prescription drug that is approved by the federal food and drug administration and |
|---|
| 43 | 43 | | is classified as an antipsychotic. |
|---|
| 44 | 44 | | (END) |
|---|
| 45 | 45 | | 1 |
|---|
| 46 | 46 | | 2 |
|---|
| 47 | 47 | | 3 |
|---|
| 48 | 48 | | 4 |
|---|
| 49 | 49 | | 5 |
|---|
| 50 | 50 | | 6 |
|---|
| 51 | 51 | | 7 |
|---|
| 52 | 52 | | 8 |
|---|
| 53 | 53 | | 9 |
|---|
| 54 | 54 | | 10 |
|---|
| 55 | 55 | | 11 |
|---|
| 56 | 56 | | 12 |
|---|