§ 20-77-123 — Drugs for asthma and other respiratory diseases - Definitions

(a) As used in this section: (1) "Drug Review Committee" means physicians and pharmacists who perform unbiased reviews of drugs to determine which drugs should be recommended for inclusion on the Preferred Drug List maintained by the Division of Medical Services of the Department of Human Services; (2) "Emergency override" means a process developed by the division that permits a pharmacist to obtain immediate permission to dispense an emergency supply of a drug prescribed by the treating physician to treat a medical emergency and for which Medicaid will provide reimbursement; (3) "Fail-first" means the requirement that a Preferred Drug List drug be utilized before the use of a non-Preferred Drug List drug; (4) "Override" means a process developed by the division that permits a physician to request review of and to seek permission to prescribe a non-Preferred Drug List drug for which Medicaid will provide reimbursement; (5) "Preferred Drug List" means a list of drugs within a class of drugs for which Medicaid will provide reimbursement without need of a prior authorization; and (6) "Unbiased review" means a review by physicians and pharmacists, selected, approved, or appointed by the division, of scientific evidence to determine the comparative effectiveness and safety of healthcare treatments of drugs within a class. (b) In the event that the division institutes a fail-first practice or policy for drugs for the treatment of asthma or other respiratory diseases, the division shall provide a process to request an override. (c) In cases of medical emergencies resulting from asthma or other acute respiratory diseases, the dispensing pharmacist shall seek an emergency override before dispensing the emergency supply of drug or drugs to treat the medical emergency condition.

Legislative History

Acts 2005, No. 2251, § 1.