Bills › 88th General Assembly
Relating to the coverage of direct-acting antiviral drugs for Medicaid beneficiaries living with a chronic hepatitis C virus infection
Topics:Health careMedicaid
Where it is now
- Done: IntroducedJanuary 15, 2019
- Done: SubcommitteeJanuary 17, 2019
- Stopped: Senate committeeDied when the General Assembly ended
- Next: Passes the Senate
- Next: House committee
- Next: Passes the House
- Next: To the Governor
- Next: Signed into law
Died when the session ended The 2020 session adjourned on June 14, 2020, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
This bill relates to coverage of direct-acting antivrial drugs for a chronic hepatitis C virus (HCV) infection under the Medicaid programs. The bill requires the department of human services (DHS) to adopt rules pursuant to Code chapter 17A, amend all Medicaid managed care contracts, and submit any Medicaid state plan amendments to the centers for Medicare and Medicaid services of the United States department of health and human services (CMS) for approval, as necessary, to require that direct-acting antiviral drugs that are approved by the United States food and drug administration (FDA) for the treatment of chronic HCV-infected patients as a medically accepted indication are a covered outpatient drug under the Medicaid program, and shall be covered consistently for Medicaid beneficiaries under both the fee-for-service and managed care methodologies in accordance with the Medicaid state plan.
Read the full explanation
The bill requires that the rules adopted, and state plan amendment submitted, shall comply with all of the following requirements: 1. 2. 3. 4. If utilization controls are provided, such utilization controls shall ensure that appropriate access to the covered drugs is consistent with federal regulations, and specifically must ensure that the drugs are provided in a manner that is sufficient in amount, duration, and scope to reasonably achieve the purpose for which the drugs are furnished and are not arbitrarily denied or reduced in amount, duration, or scope solely because of the diagnosis, type of illness, or condition of the beneficiary. The bill also requires DHS to implement programming to provide patients who are undergoing and who have completed direct-acting antiviral HCV drug treatment with supportive care and surveillance to enhance their adherence to regimens and increase success rates, and to collaborate with the department of public health, bureau of HIV, STD, and hepatitis, to provide surveillance and determine the return on investment, benefits, and outcomes resulting from the provision of treatment to all chronic HCV-infected Medicaid beneficiaries, including due to averting new infections.
Senate subcommittee
Named January 17, 2019. It hasn’t reported yet.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Lobbying
5 for · 0 against · 11 undecided · Who →