§ 32.1-331.15. Prior authorization of prescription drug products; coverageunder state plan.
A. The Committee shall review prescription drug products to recommend priorauthorization under the state plan in accordance with this article andregulations promulgated by the Board. Such review may be initiated by theDirector, the Committee itself, or by written request of the Board. TheCommittee shall complete its recommendations to the Board within no more thansix months from receipt of any such request.
B. Coverage under the state plan for any drug requiring prior authorizationshall not be approved unless the prescriber obtains prior approval of suchuse in accordance with regulations promulgated by the Board and proceduresestablished by the Department.
In formulating its recommendations to the Board, the Committee shall considerthe potential impact on patient care and the potential fiscal impact of priorauthorization on pharmacy, prescriber, hospitalization and outpatient costs.Any proposed regulation making a drug or category of drugs subject to priorauthorization shall be accompanied by a statement of the estimated impact ofsuch action on pharmacy, prescriber, hospitalization and outpatient costs.
C. The Committee shall not review any drug for which it has recommended orthe Board has required prior authorization within the previous 12 months,unless new or previously unavailable relevant and objective information ispresented.
D. Confidential proprietary information identified as such by a manufactureror supplier in writing in advance and furnished to the Committee or the Boardpursuant to this article shall not be subject to the disclosure requirementsof the Virginia Freedom of Information Act (§ 2.2-3700 et seq.). The Boardshall establish by regulation the means by which such confidentialproprietary information shall be protected.
§ 32.1-331.15. Prior authorization of prescription drug products; coverageunder state plan.
A. The Committee shall review prescription drug products to recommend priorauthorization under the state plan in accordance with this article andregulations promulgated by the Board. Such review may be initiated by theDirector, the Committee itself, or by written request of the Board. TheCommittee shall complete its recommendations to the Board within no more thansix months from receipt of any such request.
B. Coverage under the state plan for any drug requiring prior authorizationshall not be approved unless the prescriber obtains prior approval of suchuse in accordance with regulations promulgated by the Board and proceduresestablished by the Department.
In formulating its recommendations to the Board, the Committee shall considerthe potential impact on patient care and the potential fiscal impact of priorauthorization on pharmacy, prescriber, hospitalization and outpatient costs.Any proposed regulation making a drug or category of drugs subject to priorauthorization shall be accompanied by a statement of the estimated impact ofsuch action on pharmacy, prescriber, hospitalization and outpatient costs.
C. The Committee shall not review any drug for which it has recommended orthe Board has required prior authorization within the previous 12 months,unless new or previously unavailable relevant and objective information ispresented.
D. Confidential proprietary information identified as such by a manufactureror supplier in writing in advance and furnished to the Committee or the Boardpursuant to this article shall not be subject to the disclosure requirementsof the Virginia Freedom of Information Act (§ 2.2-3700 et seq.). The Boardshall establish by regulation the means by which such confidentialproprietary information shall be protected.
§ 32.1-331.15. Prior authorization of prescription drug products; coverageunder state plan.
A. The Committee shall review prescription drug products to recommend priorauthorization under the state plan in accordance with this article andregulations promulgated by the Board. Such review may be initiated by theDirector, the Committee itself, or by written request of the Board. TheCommittee shall complete its recommendations to the Board within no more thansix months from receipt of any such request.
B. Coverage under the state plan for any drug requiring prior authorizationshall not be approved unless the prescriber obtains prior approval of suchuse in accordance with regulations promulgated by the Board and proceduresestablished by the Department.
In formulating its recommendations to the Board, the Committee shall considerthe potential impact on patient care and the potential fiscal impact of priorauthorization on pharmacy, prescriber, hospitalization and outpatient costs.Any proposed regulation making a drug or category of drugs subject to priorauthorization shall be accompanied by a statement of the estimated impact ofsuch action on pharmacy, prescriber, hospitalization and outpatient costs.
C. The Committee shall not review any drug for which it has recommended orthe Board has required prior authorization within the previous 12 months,unless new or previously unavailable relevant and objective information ispresented.
D. Confidential proprietary information identified as such by a manufactureror supplier in writing in advance and furnished to the Committee or the Boardpursuant to this article shall not be subject to the disclosure requirementsof the Virginia Freedom of Information Act (§ 2.2-3700 et seq.). The Boardshall establish by regulation the means by which such confidentialproprietary information shall be protected.
