Friday, October 17, 2014

California Health Plans Mandated to Provide Standardized Drug Formulary List

This is from Chris Lewis at HealthLeaders InterStudy:
[A] new law in California that will eventually require all plans in California to use a standard formulary. The catch: It won’t happen for at least three more years. The new law, based on Senate Bill 1052, requires the two insurance state regulators (the Department of Managed Health Care and Insurance Department) to devise a standard formulary by Jan. 1, 2017. Within six months after the template is developed, all insurance plans in California, not just those on the exchange, will have to conform to that template and post regular formulary updates. 
More immediately, by Jan. 1, 2015, the law requires qualified health plans in the Covered California exchange to post their formularies on their websites and the exchange to link to them. Currently, insurers are only mandated to file their formularies with the regulatory agencies. ...  
Health plans opposed the legislation, particularly the standardization piece. One of their arguments is that plans should be able to retain the flexibility to present their drug lists and benefit designs as they see fit, in part to distinguish themselves from their competitors. ...