Subd. 3. Paragraph (a), specifies that once a formulary Senate only provision has been established a health plan company, may at any time during an contract year, expand its enrollee’s formulary by adding drugs to the formulary; reduce the copayments or coinsurance; or move a drug to a benefit category that reduces the cost. enrollee’s Paragraph (b) states that a health plan company may remove a brand name drug from its formulary or place a brand name drug in a benefit category that increases an cost only if an A-rated generic or multisource enrollee’s brand name equivalent is added to the formulary at a lower cost to the enrollee and upon 60 notice to prescribers, pharmacists, and affected enrollees. prohibits a health plan company from Paragraph (c) removing drugs from its formulary or moving drugs to a benefit category that increases an cost during enrollee’s the contract year. This prohibition does not enrollee’s apply if the change is associated with the drug being deemed unsafe by the FDA or it has been withdrawn by the FDA or the manufacturer, or an independent source has issued drug specific warnings or recommended changes in drug usage. Paragraph (d) prohibits managed care plans and county-based purchasing plans from removing drugs from its formulary or moving a drug to a benefit category that increases an cost more than enrollee’s annually unless an A-rated generic or multisource brand name equivalent is added to formulary.
Subd. 3. Paragraph (a), specifies that once a formulary has been established a health plan company, may at any time during an enrollee’s contract year, expand its formulary by adding drugs to the formulary; reduce the copayments or coinsurance; or move a drug to a benefit category that reduces the enrollee’s cost. Paragraph (b) states that a health plan company may remove a brand name drug from its formulary or place a brand name drug in a benefit category that increases an enrollee’s cost only if an A-rated generic or multisource brand name equivalent is added to the formulary at a lower cost to the enrollee and upon 60 notice to prescribers, pharmacists, and affected enrollees. Paragraph (c) prohibits a health plan company from removing drugs from its formulary or moving drugs to a benefit category that increases an enrollee’s cost during the enrollee’s contract year. This prohibition does not apply if the change is associated with the drug being deemed unsafe by the FDA or it has been withdrawn by the FDA or the manufacturer, or an independent source has issued drug specific warnings or recommended changes in drug usage. Paragraph (d) prohibits managed care plans and county-based purchasing plans from removing drugs from its formulary or moving a drug to a benefit category that increases an enrollee’s cost more than annually unless an A-rated generic or multisource brand name equivalent is added to formulary. Senate only provision
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