Panel advances bill to limit prior-authorizations for serious mental‑illness drugs

Senate Bill 20 (committee substitute) seeks to reduce barriers to prescription medications for people with serious mental illness by limiting how frequently insurers can require prior authorization for chronic maintenance drugs. The substitute adds serious mental illness to categories eligible for expedited review and sets a minimum interval between required prior authorizations for chronic maintenance drugs.

Sponsor remarks and agency testimony framed the bill as a patient-access measure: "Patients should not have to battle red tape to receive treatments that their doctors have already prescribed," Carrie Armijo, cabinet secretary of the Health Care Authority, told the committee. OSI’s life and health division director also supported the bill and cited KFF data that prior authorization is a major burden for insured adults with chronic conditions.

The committee considered a floor amendment shortening the minimum authorization interval from three years to one year. Insurers and some payers supported the change, arguing that it improves patient safety by forcing periodic clinical checks; some provider groups and disability advocates opposed shortening the period because more frequent prior-authorizations increase clinical and administrative workload. A motion to table that amendment passed 5–4, leaving the bill in its unamended form for committee consideration.

Committee members pressed sponsors on how the bill affects routine clinical care. Sponsors clarified the measure does not change the frequency of required clinical visits or refill schedules—those remain under prescriber control—and that prior authorization is the administrative step targeted by the bill. The substitute includes exceptions for cases where a generic or biosimilar is added to the formulary and preserves expedited review requirements (three-day response for standard determinations and 24-hour responses for emergencies) for certain conditions.

The committee moved and seconded a due pass motion on the committee substitute for SB20; the chair announced the bill had a due pass (no roll call recorded in the transcript).

What happens next: The bill will continue through the legislative process with a committee due-pass recommendation. Sponsors and agencies characterized the measure as balancing access and oversight; stakeholders may press for technical fixes on renewal intervals and safeguards for high-risk medications.