Provides relative to the administration of prescription drug benefits. Present law requires insurers to provide certain override procedures for physicians when step therapy or fail first protocols are utilized. Proposed law retains present law and adds a process for exemption from step therapy for patients who have clinical documentation that a prescription drug was discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event.
Proposed law provides that a plan shall not be prevented from requiring a patient to try a generic drug. Proposed law provides that a practitioner shall not be prevented from prescribing what he determines to be medically necessary.