Amendment ID: S3116-64-R1
Redraft Amendment 64
Preserving access to treatment for patients with serious mental illnesses
Messrs. Cronin, O'Connor, Eldridge and Cyr and Ms. Jehlen move that the proposed new draft be amended in section 18, in chapter 32A of the General Laws, by inserting after section 36, as inserted by said section 18, the following section:-
“Section 37. (a) For the purposes of this section, “serious mental illness” shall mean a condition, as described by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, in which an individual over the age of 18 has a diagnosable mental, behavioral or emotional disorder that causes serious functional impairment, substantially interfering with or limiting 1 or more major life activities.
(b) The commission shall not impose a prior authorization requirement or delay on prescribing and shall follow step therapy protocol pursuant to section 12A of chapter 176O for a serious mental illness drug approved by the United States Food and Drug Administration.”; and
in section 19, in chapter 175 of the General Laws, by inserting after section 47FFF, as inserted by said section 19, the following section:-
“Section 47GGG. (a) For the purposes of this section, “serious mental illness” shall mean a condition, as described by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, in which an individual over the age of 18 has a diagnosable mental, behavioral or emotional disorder that causes serious functional impairment, substantially interfering with or limiting 1 or more major life activities.
(b) Notwithstanding any other provision of law, any carrier offering a policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth shall not impose a prior authorization requirement or delay on prescribing and shall follow step therapy protocol pursuant to section 12A of chapter 176O for a serious mental illness drug approved by the United States Food and Drug Administration.”; and
in section 21, in said chapter 176A of the General Laws by inserting after section 8GGG, as inserted by said section 21, the following section:-
“Section 8HHH. (a) For the purposes of this section, “serious mental illness” shall mean a condition, as described by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, in which an individual over the age of 18 has a diagnosable mental, behavioral or emotional disorder that causes serious functional impairment, substantially interfering with or limiting 1 or more major life activities.
(b) Notwithstanding any other provision of law, a nonprofit hospital service corporation shall not impose a prior authorization requirement or delay on prescribing and shall follow step therapy protocol pursuant to section 12A of chapter 176O for a serious mental illness drug approved by the United States Food and Drug Administration.”; and
in section 22, in chapter 176B of the General Laws by inserting after section 4GGG, as inserted by said section 22, the following section:-
“Section 4HHH. (a) For the purposes of this section, “serious mental illness”, shall mean a condition, as described by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, in which an individual over the age of 18 has a diagnosable mental, behavioral or emotional disorder that causes serious functional impairment, substantially interfering with or limiting 1 or more major life activities.
(b) Notwithstanding any other provision of law, a subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall not impose a prior authorization requirement or delay on prescribing and shall follow step therapy protocol pursuant to section 12A of chapter176O for a serious mental illness drug approved by the United States Food and Drug Administration.”; and
in section 24, in chapter 176G of the General Laws by inserting after section 4XX, as inserted by said section 24, the following section:-
“Section 4YY. (a) For the purposes of this section, “serious mental illness”, shall mean a condition, as described by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, in which an individual over the age of 18 has a diagnosable mental, behavioral or emotional disorder that causes serious functional impairment, substantially interfering with or limiting 1 or more major life activities.
(b) Notwithstanding any other provision of law, a health maintenance organization organized pursuant to this chapter shall not impose a prior authorization requirement or delay on prescribing and shall follow step therapy protocol pursuant to section 12A of chapter 176O for a serious mental illness drug approved by the United States Food and Drug Administration.”.