HOUSE DOCKET, NO. 3247        FILED ON: 1/14/2009

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2351

The Commonwealth of Massachusetts

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In the Year Two Thousand Nine

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An Act Regulating Appeals under the Group Insurance Commission..

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1.  Chapter 32A of the General Laws is hereby by amended, at the end thereof, the following new section:-

Section 17J. Any person who is dispensed a non-formulary or non-preferred brand name prescription drug, as determined under a pharmaceutical drug program established by the commission or through a pharmacy benefit manager contracted by the commission, may appeal that determination to the commission, and upon the submission of a statement by the person’s physician that, due to a medical necessity, only the non-formulary or non-preferred brand name prescription drug can be dispensed, the person shall pay for the drug at the same rate required for the formulary or preferred brand name prescription drugs under such pharmaceutical drug program.