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Bill would prevent mid-year formulary demotions for enrollees; committee adopts amendment and lays it over
Summary
House File 1652 would prohibit health plans from removing or moving a prescribed drug to a more costly tier for an enrollee during the plan year if the enrollee was already prescribed that drug at enrollment.
Representative Steve Elkins presented House File 1652 as a measure to preserve continuity of drug coverage for enrollees who select a health plan based on a drug that is on that plan’s formulary at enrollment. "Sometimes bills like this are called formulary freeze bills. This is not a formulary freeze bill," Elkins told the committee, explaining the sponsor’s intent to allow plans to add new drugs but not to remove or demote drugs for current enrollees during the plan year.
Medical and patient advocates described clinical risks when plans change formularies midyear. Dr.…
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