Ohio SB387 mandates Medicaid managed care coverage for pharmacogenomic testing and outlines requirements for prior authorization.

Ohio SB387 requires Medicaid managed care organizations to cover pharmacogenomic testing, which evaluates how an individual's genetic profile may impact the efficacy, safety, or toxicity of a prescribed drug. The bill specifies that such testing is considered medically necessary if ordered by a treating prescriber for a Medicaid enrollee diagnosed with depression or anxiety. It allows Medicaid managed care organizations to impose prior authorization requirements, but these must provide a clear pathway to coverage, require minimal documentation, and not create undue administrative burdens.

Ohio SB387 mandates Medicaid managed care coverage for pharmacogenomic testing and outlines requirements for prior authorization.

Ohio SB387 requires Medicaid managed care organizations to cover pharmacogenomic testing, which evaluates how an individual's genetic profile may impact the efficacy, safety, or toxicity of a prescribed drug. The bill specifies that such testing is considered medically necessary if ordered by a treating prescriber for a Medicaid enrollee diagnosed with depression or anxiety. It allows Medicaid managed care organizations to impose prior authorization requirements, but these must provide a clear pathway to coverage, require minimal documentation, and not create undue administrative burdens.