Sen. Michael W. Frerichs
Filed: 5/5/2009
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1 | AMENDMENT TO HOUSE BILL 152
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2 | AMENDMENT NO. ______. Amend House Bill 152 on page 2, | ||||||
3 | immediately below line 21, by inserting the following: | ||||||
4 | "Section 15. Provision of notice; formulary changes. | ||||||
5 | (a) This Section shall apply solely to cases of | ||||||
6 | immunosuppressive therapy when an immunosuppressive drug has | ||||||
7 | been prescribed to a patient to prevent the rejection of | ||||||
8 | transplanted organs and
tissues. The notification shall | ||||||
9 | disclose the formulary change, indicate that the prescribing | ||||||
10 | physician may initiate an appeal, and include information | ||||||
11 | regarding the procedure for the prescribing physician to | ||||||
12 | initiate the policy or plan sponsor's appeal process. | ||||||
13 | (b) At least 60 days prior to making any formulary change | ||||||
14 | that alters the terms of coverage for a patient receiving | ||||||
15 | immunosuppressant drugs or discontinues coverage for a | ||||||
16 | prescribed immunosuppressive drug that a patient is receiving, | ||||||
17 | a policy or plan sponsor must notify the prescribing physician |
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1 | and the patient, or the parent or guardian if the patient is a | ||||||
2 | child, or the spouse of a patient who is authorized to consent | ||||||
3 | to the treatment of the patient. The notification shall | ||||||
4 | disclose the formulary change, indicate that the prescribing | ||||||
5 | physician may initiate an appeal, and include information | ||||||
6 | regarding the procedure for the prescribing physician to | ||||||
7 | initiate the policy or plan sponsor's appeal process.".
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