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Introduced Version House Bill 2216 History

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hb2216 intr
H. B. 2216


(By Delegate Susman)
[Introduced February 11, 2005; referred to the
Committee on Health and Human Resources then the Judiciary.]




A BILL to amend the code of West Virginia, 1931, as amended, by adding thereto a new article, designated §9-4E-1 and §9-4E-2, all relating to exempting certain physicians from obtaining preauthorization before dispensing psychotrophic medications to mentally ill medicaid recipient patients in order to avoid catastrophic results from inadequate and untimely treatment; and providing findings by the Legislature.

Be it enacted by the Legislature of West Virginia:
That the code of West Virginia, 1931, as amended, be amended by adding thereto a new article, designated §9-4E-1 and §9-4E-2, all to read as follows:
ARTICLE 4E. MEDICAID PREAUTHORIZATION EXEMPTION FOR CERTAIN PHYSICIANS TREATING MENTALLY ILL.

§9-4E-1. Findings.

The Legislature hereby makes the following findings:
(a) Mentally ill patients who are recipients of medicaid have the least means to obtain proper medications to control their mental illness.
(b) These medicaid recipients, if not promptly treated and then, maintained on medications which work, will, by their uncontrolled mental illnesses suffer greatly, often inflicting significant harm to themselves and other persons, and consequently, increase costs to society as a whole.
(c) The current belief of the scientific medical community is that major mood disorders, such as bipolar disorder, schizophrenia and other psychotic disorders, if not promptly treated, may cause organic brain damage which leads to limited true recovery when the disorders are treated, thus decreasing the prospect of mentally ill persons being able to return to optimum health, to work or to family.
(d) It is ethically imperative that the specialists in the medical neurosciences have unfettered ability to promptly medically intervene in treating new acute mentally ill patients and to continue proven medications for those patients.
(e) The procedure of the West Virginia Medicaid Pharmacy of requiring preauthorization before dispensing medications to mentally ill medicaid recipients is unduly arduous and difficult and most of all, too time consuming for practitioners with large numbers of mentally ill patients who require immediate treatment to avoid permanent injury or other undesirable consequences.
(f) The imposition of a "first fail" plan before a physician can adjust or change a medication not on the approved list of psychotrophic medications is medically and psychiatrically unsound and the seriously mentally ill patient's condition will usually not remain stable for long without prompt treatment. If these persons are not sooner and more promptly treated, a significant probability exists that a sharp increase in hospitalizations will result, thereby increasing medical costs to the State.
§9-4E-2. Preauthorization exemption for certain physicians.

Physician specialists in neurosurgery, neurology or psychiatry with appropriate residency training to have been Board eligible at the time of completing their residency training and to sit for their specialty examinations, as well as neurosurgeons, neurologists and psychiatrists in post-graduate training programs, may prescribe to medicaid recipients suffering serious mental illness, psychotrophic medications, without the requirement of any preauthorization procedure otherwise required. For the purposes of this article, "psychotrophic medications" mean FDA approved antipsychotics, neuroleptics (typical and atypical), antidepressants, mood stabilizers, antianxiety agents, hypnotics, stimulants, antiParkinson agents and antiAlzheimer agents.


NOTE: The purpose of this bill is to exempt certain physicians from obtaining preauthorization before being able to dispense psychotrophic medications to mentally ill medicaid recipient patients.

This article is new; therefore, strike-throughs and underscoring have been omitted.
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