Are there any laws governing the prescription of drugs in managed care and other cost containment programs?

In Washington, there are a few laws governing the prescription of drugs in managed care and other cost containment programs. The Washington State Office of the Insurance Commissioner (OIC) oversees how these programs operate in the state. One of the laws the OIC enforces is the Pharmacy Benefit Manager Licensing Act, which sets standards for managed care organizations to ensure the safety and effectiveness of prescription drugs. The law requires that these organizations obtain an annual license from the OIC and submit an annual report of their activities to the commissioner. The law also requires organizations to provide consumers with a list of covered drugs and other information, such as descriptions of cost-sharing requirements and appeal rights if a patient’s drug isn’t covered. The OIC also enforces the Managed Care Prescription Drug Reform Act, which is designed to ensure that Washington consumers have access to a broad range of prescription medications when they enroll in a managed care plan. The law requires managed care organizations to cover a certain number of drugs in each therapeutic class and prohibits them from charging higher cost-sharing amounts for certain medications. Finally, the OIC enforces the Prescription Drug Cost Transparency Act, which requires managed care organizations to provide consumers with information about the costs of medications and generic alternatives. This law also requires managed care organizations to offer incentives for generic drug dispensing and to set limits on out-of-pocket costs for prescription medications. Overall, these laws are designed to ensure that Washington consumers have access to high-quality, affordable prescription drugs when they enroll in managed care and other cost containment programs.

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Are there any laws governing the prescription of drugs in managed care and other cost containment programs?

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