Prior Authorization Requirements Restricted for Certain Prescriptions

On Aug. 28, 2018, Gov. Carney signed HB 441 into law, which became effective on the date of signing. The new law prohibits pharmacy benefit managers from requiring a prior authorization for an initial prescription for a narcotic or benzodiazepine drug that’s prescribed in an emergency situation for 72 hours or less. An emergency is defined as a situation that will result in the loss of life, limb or organ function.

Additionally, the new law prohibits a pharmacy benefits manager from requiring a prior authorization for a prescription medication related to a chronic or long-term condition more frequently than once per 12 months. For this purpose, the prescription medication must be necessary for the life of the patient.

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