HB2388ham001 103RD GENERAL ASSEMBLY

Rep. Lindsey LaPointe

Filed: 3/24/2023

10300HB2388ham001 LRB103 30755 KTG 59822 a

AMENDMENT TO HOUSE BILL 2388

AMENDMENT NO. ______. Amend House Bill 2388 by replacing everything after the enacting clause with the following:

"Section 5. The Illinois Public Aid Code is amended by adding Sections 5-5.12f and 5-5.12g as follows:

(305 ILCS 5/5-5.12f new)

Sec. 5-5.12f. Prescription drugs for mental illness; no utilization or prior approval mandates. Notwithstanding any other provision of this Code to the contrary, for the purpose of removing barriers to the timely treatment of serious mental illnesses, insurance cost containment prior authorization mandates and insurance utilization management controls shall not be imposed under the fee-for-service and managed care medical assistance programs on any FDA approved prescription drug that is recognized by a generally accepted standard medical reference as effective in the treatment of conditions specified in the most recent Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.

(305 ILCS 5/5-5.12g new)

Sec. 5-5.12g. Non-controlled prescription medications to treat mental illness.

(a) As used in this Section:

"DSM-5 criteria" means the diagnostic criteria established in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

"FDA" means the United States Food and Drug Administration.

(b) Notwithstanding any other provision of this Code to the contrary, on and after July 1, 2023, all non-controlled FDA-approved prescription medications for the treatment of a serious mental illness, as defined by the Department of Human Services, shall be covered under the medical assistance program for persons otherwise eligible for medical assistance who are diagnosed with a mental disorder that meets DSM-5 criteria and which is the focus of the treatment provided, including, but not limited to, schizophrenia, schizo-affective disorders, bipolar disorders, post-traumatic stress disorder, and major depressive disorder, including postpartum depression. Prescription medications covered under this Section shall not be subject to any prior authorization mandate or lifetime restriction limit mandate. For any medication covered under this Section that contains an opioid antagonist, the prescriber shall check the Illinois Prescription Monitoring Program to determine if the patient is being actively prescribed an opioid. The prescriber of a non-controlled FDA-approved prescription medication must be a board-certified psychiatrist or a medical professional with prescribing authority that routinely treats patients with a serious mental illness.

Section 99. Effective date. This Act takes effect July 1, 2023.".