Lawmakers seek more regulation of mental health drugs

? A legislative oversight committee agreed Tuesday that lawmakers should consider repealing a law that prohibits the state Medicaid system from regulating powerful, and very expensive, mental health drugs.

Rep. David Crum, R-Augusta, who chairs a committee that oversees Medicaid programs, said that issue should at least be considered by the 2015 Legislature. His motion passed without dissent and will become part of the oversight committee’s recommendation to the Legislature.

Under a law passed in 2002, the state Medicaid system is specifically prohibited from requiring prior authorization or using any other restrictions on the use of drugs that treat illnesses such as schizophrenia, depression or bipolar disorders.

That includes an entire class of drugs called “atypical antipsychotic” medicines such as Abilify and Seroquel, two of the most expensive drugs for the Medicaid program. In a typical year, Medicaid officials have said, the state spends more money buying those drugs than it does for any other drug on the market.

Those drugs are often marketed directly to consumers through TV and print advertising, promoting their use in combination with other drugs used to treat depression.

Despite the fact that the drugs are not approved to treat conditions such as dementia or Alzheimer’s, a report last year by the Center for Medicare and Medicaid Services found Kansas ranked third in the nation for the percentage of elderly nursing home patients being prescribed such drugs.

“It’s used as a staffing device,” said Sen. Laura Kelly, D-Topeka. “If you under-staff your nursing homes, then you’re going to have to use something to provide safety and security to those patients, and one way to do that is through medication.”

State Medicaid officials have previously argued for repealing the law, but they’ve run into opposition from health care lobby groups who say it actually protects patients and health care providers.

The drugs are also prescribed for other mental health patients. In fact, several national studies have also documented an increase in the prescription of those drugs to children, even though the Food and Drug Administration has never approved their use in children.

“Placing restrictions on these medications can result in unnecessary visits to the emergency room, admission to state mental health hospital programs, or incarceration,” said Kyle Kessler, a lobbyist for the Association of Community Mental Health Centers of Kansas.

Amy Campbell, a lobbyist for the Kansas Mental Health Coalition, said the exemption for mental health drugs saves the state money. She cited studies that, according to her, show other states that allow restrictions on those drugs have seen their Medicaid costs go up.