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. 

Stakeholder draft released on November 20, 2019

Stakeholder meeting

  • December 16, 2019 at 4:00 p.m.
  • Tumwater Office: 5000 Capitol Blvd. SE, Tumwater, WA 98501
  • Directions to the Tumwater office. 
  • Call in option: (360) 407-3780 PIN Code: 705669#

Comments

  • The comment period for the stakeholder draft is open until December 31, 2019.
  • Submit comments to the rules coordinator.

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