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1999 SESSION

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HB 2619 Prescription drug formularies.

Introduced by: S. Chris Jones | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Prescription drug formularies. Requires any prescription drug formulary applied by any (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis; (ii) corporation providing individual or group accident and sickness subscription contracts; and (iii) health maintenance organization providing a health care plan for health care services to be developed only after consultation and approval by a pharmacy and therapeutics committee made up of a majority of members who are licensed physicians. The bill also requires each insurer, corporation, or health maintenance organization to establish an expeditious process or procedure that allows covered individuals to obtain appropriate nonformulary drugs without prior approval. The covered individual would be responsible for the payment of any costs of the nonformulary prescription drug which exceeds the cost the insurer, corporation, or health maintenance organization would pay for the prescription drug on the formulary which is intended to address the medical condition of the enrollee for which the nonformulary drug is prescribed.


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