When a healthcare insurer uses a formulary for prescription drugs, the insurer shall include a written procedure whereby covered persons can obtain, without penalty and in a timely fashion, specific drugs and medications not included in the formulary when:
(1) The formulary's equivalent has been ineffective in the treatment of the covered person's disease or condition; or
(2) The formulary's drug causes or is reasonably expected to cause adverse or harmful reactions in the covered person.
Section: Previous 23-99-402 23-99-403 23-99-404 23-99-405 23-99-406 23-99-407 23-99-408 23-99-409 23-99-410 23-99-411 23-99-412 23-99-413 23-99-414 23-99-415 23-99-416 NextLast modified: November 15, 2016