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2017 SESSION
HB 1755 Step therapy protocols; disclosures.
Introduced by: Glenn R. Davis | all patrons ... notes | add to my profiles
SUMMARY AS INTRODUCED:
Step therapy protocols; disclosures. Requires health insurers that limit coverage for prescription drugs through the use of a step therapy protocol to have in place a process for a prescribing provider to request an override of the protocol for a patient. A step therapy protocol is a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition are medically appropriate for a particular patient and are covered by a health benefit plan or that conditions coverage of a prescription medication on a patient first trying an alternative medication without success. The measure requires the granting of a step therapy protocol override in certain circumstances. Finally, the measure requires an insurer that offers a health benefit plan that uses a step therapy protocol to provide (i) written notice of a determination that the protocol requires denial of coverage of a provider's selected prescription drug, (ii) an explanation of the basis for such determination, and (iii) notice of the procedures for submitting a request for an override of the restrictions of the step therapy protocol.
FULL TEXT
HISTORY
- 01/08/17 House: Prefiled and ordered printed; offered 01/11/17 17101997D
- 01/08/17 House: Referred to Committee on Commerce and Labor
- 01/12/17 House: Assigned C & L sub: Subcommittee #2
- 01/24/17 House: Subcommittee failed to recommend reporting (4-Y 6-N)
- 02/08/17 House: Left in Commerce and Labor