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The bill has an
effective date of January 1, 2019, so only contracts executed after January
1, 2019 will be required to meet the coverage in this bill. Thus, the State
Employee Health Plan (SEHP) will have no General Fund appropriations or
Highway Fund allocations in the current biennium. Drug step therapy is the
practice of beginning drug therapy for a medical condition with the most
cost-effective and safest drug and progressing to other more costly or risky
therapies only if necessary, with the goal of controlling costs and
minimizing risks. This bill adds an exception process that must be clear,
readily accessible and convenient to the patient and prescriber. This could
lead to additional or longer lasting exceptions from the drug step therapy
process, which could potentially increase costs in future bienniums for
insurers, including the SEHP. However, there is not enough information
available to identify a fiscal impact at this time. |