HR 3274 · 106th Congress · Health
Patients' Formulary Rights Act of 1999
Bill Progress
✓
Introduced2
Committee3
House Vote4
Senate5
EnactedLatest: Referred to the Subcommittee on Health.(1999-11-17)
Plain Language Summary
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Patients' Formulary Rights Act of 1999 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code to prohibit a group health plan, and the insurance issuer offering such coverage, from using a formulary (a plan which limits the particular drugs for which coverage will be available) unless the plan or issuer: (1) notifies participants, beneficiaries, and enrollees in advance about, and makes available to treating health care professionals under the plan, specified information concerning the formulary; (2) notifies such individuals of any changes in the formulary; and (3) when a drug is removed from the formulary, permits an individual to continue to have the drug prescribed for treatment of the same condition. Includes within required formulary information: (1) the extent of therapeutic substitution; (2) a complete list of all drugs included in the formulary; (3) information on access to nonformulary drugs; (4) whether or not, and to what extent, coverage will exist for nonformulary drugs; (5) copayments or other cost-sharing for formulary drugs; and (6) limits on coverage payments for outpatient formulary and nonformul…
Summarized by Claude AI · Non-partisan · For informational purposes only