Florida must end Medicaid delays for schizophrenia treatment
As a longtime advocate for mental health, working alongside other parents and peers, I've heard far too many stories from patients and families whose lives have been upended by schizophrenia.
I've also seen the impact of this condition in my personal life — my son has schizophrenia. As an advocate and a mother, I find it disturbing how often access to the most effective treatment is delayed because Florida's Medicaid program forces patients to fail on alternative medications through a policy known as step therapy.
Step therapy is a method of mental health treatment that requires a patient to try a series of treatments, typically starting with the least expensive and least invasive options, before moving on to more intensive treatments if necessary. The approach is commonly used in insurance-covered mental health treatments.
This trial-and-error process can require patients to try up to three different medications, taking months.
For someone living with schizophrenia, that kind of delay can mean the difference between stability and crisis.
Schizophrenia is not a condition where 'trial and error' works well. Delayed treatment or ineffective medications can lead to hospitalization, incarceration or even homelessness. Every day without the right treatment increases the risk of irreversible harm.
Yet Florida's current policies ignore clinical judgment and prioritize potential cost savings over patient safety.
During the last legislative session, Senate Bill 264, which would have ended step therapy protocols, died in committee.
Fortunately, Florida's Medicaid Pharmaceutical & Therapeutics Committee has an opportunity to update these rules during its virtual meeting on June 27.
The committee is responsible for developing and implementing a Medicaid preferred drug list, as mandated by the Florida Legislature in 2000.
This update is urgently needed. In my case, it's personal. I've worked directly with individuals living with serious mental illness, and I've also walked this journey with my son. I see how step therapy frustrates providers trying to do what's best for their patients.
Psychiatrists are forced to prescribe medications they know won't work — or that have already failed a patient — just to meet step therapy requirements. Even new and innovative treatments with fewer side effects are often out of reach due to this outdated policy.
I hope the committee will consider the harmful impact these requirements have on Floridians and make the decision to put patients first by removing step therapy for medications that treat schizophrenia.
If Florida's leaders are serious about addressing mental health in our state, this is a crucial step. With better access to the right treatments, we'll see fewer hospitalizations, better health outcomes—and cost savings for the state.
Florida must give people living with schizophrenia a fighting chance, starting by ensuring they get the care they need, when they need it.
Marilyn Ricci is a family advocate, a member of the National Alliance on Mental Illness (NAMI) in Palm Beach and a former president of NAMI's national organization. Those interested can watch the virtual meeting here starting at 8:30 a.m. Friday
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