Medicaid recipients could not be denied certain prescription medication coverage under a bill advanced from general file July 22.
LB1052, introduced by Lincoln Sen. Anna Wishart, would prohibit the state Department of Health and Human Services, a managed care organization or a contracted pharmacy benefit manager from denying coverage of antidepressant, antipsychotic or anticonvulsant medication if the patient’s health care provider deemed the drug medically necessary.
Wishart said she introduced LB1052 after learning about a mentally ill man named Curtis. He overcame suicidal ideation in 2006 and was stable and independent for 11 years, she said, benefitting from a drug that was later removed from the preferred drug list. Unable to afford the medication, Curtis became delusional, attempted suicide, was hospitalized five times and moved into an assisted living facility where he remains, Wishart said.
“While he’s back on the original drug his managed care organization denied him originally, Curtis may never go back to the level of independence he had for 10 years,” Wishart said. “This has to change.”
A Health and Human Services Committee amendment added provisions from two bills–LB847 and LB887–originally introduced by Sen. John Arch of LaVista. The amendment would change pharmacy provisions at long-term care facilities, allow a pharmacist, in certain circumstances, to adapt a prescription for a patient at the request of the patient and allow a pharmacist to package medications for a patient that have been dispensed from a different pharmacy.
Arch said the changes would allow for only minor modifications to prescriptions.
“Pharmacists are not changing prescriptions or writing prescriptions,” he said.
Lincoln Sen. Suzanne Geist supported the bill, saying it can be extremely difficult to find a medication that stabilizes someone with mental illness. Subsequent changes in medication or dosage can cause upheaval in an individual’s life, she said.
Sen. Steve Lathrop of Omaha also supported the bill. Any cost savings associated with switching a prescribed drug are miniscule compared to the damage the change could cause to a patient, he said.
“When you lock in on what works for an individual, you don’t want to change it,” Lathrop said.
Lawmakers adopted the committee amendment 41-0 and advanced LB1052 to select file 42-0.