§ 23-99-409 - Prescription drug formulary.
23-99-409. Prescription drug formulary.
When a health care insurer uses a formulary for prescription drugs, the insurer shall include a written procedure whereby covered persons can obtain, without penalty and in a timely fashion, specific drugs and medications not included in the formulary when:
(1) The formulary's equivalent has been ineffective in the treatment of the covered person's disease or condition; or
(2) The formulary's drug causes or is reasonably expected to cause adverse or harmful reactions in the covered person.