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Minutes for HB2259 - Committee on Health and Human Services
Short Title
Providing that certain mental health medications be available without prior authorization to treat medicaid recipients and abolishing the mental health medication advisory committee.
Minutes Content for Tue, Feb 14, 2023
Kyle Kessler, Executive Director, Association of Community Mental Health Centers of Kansas (ACMHCK), provided testimony in support of HB2259 (Attachment 11). Mr. Kessler provided the history leading up to the bill. It was noted that in 2015 based on a theory that limiting access to mental health medications would help solve the budgetary challenges related to pharmaceutical expenditures, SB123 (2015) was passed and significantly changed the authorization of mental health medications, creating a new layer of bureaucratic red tape between doctors and patients.The Mental Health Medication Advisory Committee (MHMAC) was created tasked with creating policies for authorizing and prescribing mental health medication for Medicaid beneficiaries. This has created an administrative issue with providers that is only exacerbated by the workforce shortage. The ACMHCK strongly supports reverting to the previous statutory policy of prohibiting prior authorization of mental health medications and placing the responsibility for prescribing decisions with the medical team providing direct patient care.
Mr. Kessler responded to questions from the committee.
Dr. Will Warnes, Medical Director, Association of Community Mental Health Centers of Kansas, provided testimony in support of HB2259 (Attachment 12). Dr. Warnes noted that when he arrived in Kansas in 2011, he was surprised to find no Medicaid restrictions in prescribing psychotropic medications not on the preferred drug list. This allowed for the proper medication for my patients, 80% being Medicaid patients, that was both the safest and most helpful for their mental health symptoms. Prior authorizations have increased with noticeable delays in being notified of a prior authorization. This has led to a decrease in our ability to respond to patient needs. Dr. Warnes provided an example related to differences in blood pressure medications. Prior authorizations that are enforcing clinical guidelines begin to through whole classes of medications into the prior authorization process. As a member of the MHMAC we have recently eliminated seven prior authorization policy elements. While continuing to work through the MHMAC I believe passage of HB2259 would be an improvement to care for those with mental health issues.
Dr. Warnes responded to questions from the committee.
Amy Campbell, Kansas Mental Health Coalition (KMHC), provided testimony in support of HB2259 (Attachment 13). The Coalition supports improving access to mental health medications and reducing administrative burdens on the mental heal workforce. Research is plentiful to show that interruptions in treatment result in emergency room visits, repeated hospitalizations, homelessness, incarceration and even death by suicide. Mental health consumers need medication to recover, alleviate symptoms and make the "illness" manageable. Access to a full range of FDA approved medications promotes successful treatment. KMHC opposes step therapy and prior authorization medications which focus on costs rather than drug efficacy.
Madison Elliott, Public Policy & Advocacy Director, NAMI Kansas, provided testimony in support of HB2259 (Attachment 14). NAMI Kansas' supports the elimination of the imposition of requirements for prior authorizations and other restrictions on medications used to treat mental illness. The organization also supports the abolishment of the MHMAC. A detailed list of the organizations reasons was provided.
The following provided written only in support:
Dantia MacDonald, Private Citizen (Attachment 15)
