For Consumers

Prescription drug utilization management (R 2019-11)

The Legislature passed ESHB 1879 during the 2019 session. It requires health carriers and prescription drug utilization management companies, which restrict prescription drug coverage through utilization management protocols, to provide the patient and prescribing practitioner access to a clear, readily accessible and timely exception process. It also requires utilization management protocols to be evidence based and creates requirements and timelines for step therapy exception requests. The Office of the Insurance Commissioner will develop rules to establish how the notice to participating providers would be given the standard process requirements and external review options. 

Notice to start rulemaking

Comments

  • The comment period for the CR-101 is open until: Dec. 31, 2019
  • Please submit comments to the rules coordinator