Section 11 (62M.02, subd. 12) modifies the definition of Senate only provision health benefit plan to include a health plan that provides coverage of prescription drugs. Section 12 (62M.02, subd. 14) modifies the definition of Senate only provision to include prescription drugs. “outpatient services” Section 13 (62M.02, subd. 14b) adds a definition for Senate only provision “prescription.” Section 14 (62M.02, subd. 14c) adds a definition for Senate only provision drug “prescription order.” Section 15 (62M.02, subd. 15) modifies the definition Senate only provision of to include preadmission review, “prior authorization” pretreatment review, pharmaceutical utilization management procedures, utilization, and case management and any utilization review requirement that an enrollee organization’s or provider notify the utilization review organization prior to providing a service. modifies the definition Senate only provision Section 16 (62M.01, subd. 17) of to include a licensed pharmacist. “provider” adds a definition for Senate only provision Section 17 (62M.01, subd. 18a) “quantity limit.” Section 18 (62M.01, subd. 19a) adds a definition for Senate only provision “step therapy.” Section 19 (62M.05, subd. 3a) modifies the time in which an Senate only provision initial determination on requests for utilization review must be communicated to the provider and enrollee from ten business days to five business days of the request.
Section 11 (62M.02, subd. 12) modifies the definition of health benefit plan to include a health plan that provides coverage of prescription drugs. Senate only provision Section 12 (62M.02, subd. 14) modifies the definition of “outpatient services” to include prescription drugs. Senate only provision Section 13 (62M.02, subd. 14b) adds a definition for “prescription.” Senate only provision Section 14 (62M.02, subd. 14c) adds a definition for “prescription drug order.” Senate only provision Section 15 (62M.02, subd. 15) modifies the definition of “prior authorization” to include preadmission review, pretreatment review, pharmaceutical utilization management procedures, utilization, and case management and any utilization review organization’s requirement that an enrollee or provider notify the utilization review organization prior to providing a service. Senate only provision Section 16 (62M.01, subd. 17) modifies the definition of “provider” to include a licensed pharmacist. Senate only provision Section 17 (62M.01, subd. 18a) adds a definition for “quantity limit.” Senate only provision Section 18 (62M.01, subd. 19a) adds a definition for “step therapy.” Senate only provision Section 19 (62M.05, subd. 3a) modifies the time in which an initial determination on requests for utilization review must be communicated to the provider and enrollee from ten business days to five business days of the request. Senate only provision
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