The bill amends the Michigan Insurance Code of 1956, specifically section 3406o, to enhance the requirements for insurers regarding health insurance policies that cover prescription drugs. It mandates that insurers must involve participating physicians, dentists, and pharmacists in the development of drug formularies, disclose formulary restrictions to healthcare providers and insured individuals, and allow exceptions for nonformulary drugs when they are deemed medically necessary. Additionally, the bill establishes timelines for insurers to respond to requests for expedited reviews of nonformulary alternatives, requiring a determination within 24 hours in urgent situations and within 72 hours for standard requests.

Furthermore, the bill repeals section 3406w of the Insurance Code, which may have previously imposed additional requirements or limitations on the coverage of nonformulary drugs. The changes aim to improve access to necessary medications for patients while ensuring that insurers maintain a transparent and responsive process for handling formulary exceptions.

Statutes affected:
Senate Introduced Bill: 500.3406
As Passed by the Senate: 500.3406