An Act relative to the treatment of epilepsy and seizure disorders

This bill directs MassHealth and its contracted health insurers to create a step therapy program for prescription medications used to treat epilepsy and seizure disorders. Under this program, patients would generally need to try and fail on one alternative medication before their specific prescribed drug is authorized for coverage. However, doctors can request an immediate override of this requirement if the patient has previously failed the preferred treatment, if the standard regimen is expected to be ineffective based on the patient's specific characteristics, if the preferred treatment poses a risk of harm, or if it is medically necessary for the patient's best interest. Additionally, the bill limits this step therapy requirement to a maximum of thirty days, after which the doctor can determine the treatment is clinically ineffective and ensure the medication is covered.