Status: Enacted
Year Enacted: 2014
Notwithstanding any other provision of law, on or after the effective date of this amendatory Act of the 99th General Assembly, every insurer licensed in this State to sell a policy of group or individual […]
Status: Enacted
Year Enacted: 2014
A health insurer that provides prescription drug benefits must, within 72 hours after receipt of a paper or electronic prior authorization form from a prescribing provider or pharmacist, either approve or deny the prior authorization. […]
215 Ill. Comp. Stat. § 5/370c. Mental and emotional disorders: Accident and Health Insurance – Illinois
Status: Enacted
Year Enacted: 1977
Plans shall shall provide coverage based upon medical necessity for the treatment of a mental, emotional, nervous, or substance use disorder or condition in parity with physical treatments. Plans shall not impose additional prior authorization […]
Status: Enacted
Year Enacted: 2010
The Health Carrier External Review Act’s purpose is to provide uniform standards for the establishment and maintenance of external review procedures. Statutes set out timeline and process for a standard review.
Status: Enacted
Year Enacted: 2016
Each medicaid managed care entity shall have an updated provider directory. Medicaid Managed Care Entities shall publish on their respective websites a formulary for each plan offered and make the formularies easily understandable and publicly […]
Status: Enacted
Year Enacted: 1998
Describes the information that must be provided by a managed care plan to enrollees.
Status: Enacted
Year Enacted: 2016
Governs PBM cost transparency requirements.
Status: Enacted
Year Enacted: 1993
If the program of health benefits provides coverage for prescribed drugs approved by the federal Food and Drug Administration for the treatment of certain types of cancer, it may not exclude coverage of any drug […]
63 Pa. Cons. Stat. § 390-8. Unlawful acts: Pharmacy Acts – Pennsylvania
Status: Enacted
Year Enacted: 1961
It shall be unlawful for any pharmacist to dispense an emergency prescription, unless the pharmacist does the specified. For example, the pharmacist must first attempt to obtain an authorization from the authorized prescriber and cannot […]
Status: Enacted
Year Enacted: 2003
Medicaid shall make available the preferred drug list to Alabama Medicaid providers
Status: Enacted
Year Enacted: 2003
Until Medicaid adopts the preferred drug list, Medicaid shall continue to use its existing voluntary preferred drug list and prior authorization program
Status: Enacted
Year Enacted: 1996
Each insurer, health service corporation, and health benefit that issues or renews any policy of accident or health insurance providing benefits for medical or hospital expenses for its insured persons shall pay for services rendered […]
Status: Enacted
Year Enacted: 2000
A health care insurance policy must contain certain provisions.
Status: Enacted
Year Enacted: 2012
A health care insurer that offers, issues, delivers, or renews a health care insurance plan in the individual or group market in the state that provides coverage for prescription drugs for which cost sharing, deductibles, […]
Status: Enacted
Year Enacted: 2000
Regulates contracts between health care providers and insurers, stating that a contract may not contain a provision that the provider be compensated for medical care services performed at the same rate as the provider has […]
Status: Enacted
Year Enacted: 1977
A health care insurer that offers, issues for delivery, or renews in the state a health care insurance plan in the group or individual market that provides certain benefits listed in this chapter shall also […]
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