Healthcare (Prescription Drugs)

This bill establishes a bipartisan task force to study prescription drug shortages and develop strategies to prevent them. The task force will include representatives from healthcare providers, insurance companies, tribal leaders, and state agencies, who will meet annually to identify at-risk medications and recommend solutions. It also expands an existing state program to help local companies increase production capacity for essential drugs. Additionally, the bill maintains existing rebate requirements for pharmaceutical manufacturers selling drugs covered by state medical assistance programs.

HB 5040 updates cash assistance rates for the state's general assistance program, setting monthly payments at $269 for unemployable individuals, $200 for transitional people paying shelter costs, and $50 for others not paying shelter. It creates a new "working persons with disabilities" Medicaid program allowing disabled workers earning under $85,000 annually to qualify for medical assistance, with asset limits of $20,000 for singles and $30,000 for couples, plus specific income disregards. The bill also modifies drug formulary rules to require prior authorization for nonpreferred drugs (except mental health drugs filled recently) and excludes antiretroviral drugs from preferred lists. These changes directly affect low-income residents, disabled workers seeking Medicaid, and Medicaid patients using prescription drugs.

This bill modifies Medicaid prescription drug coverage rules by changing step therapy requirements. It mandates that step therapy (requiring patients to try lower-cost drugs first) follow manufacturer and FDA guidelines when available. If no such guidelines exist, step therapy cannot exceed 30 days, after which prescribing doctors may bypass the requirement if they determine the initial treatment is ineffective for the patient. The bill directly affects Medicaid patients and their healthcare providers, streamlining access to prescribed medications under the Medicaid program.