BILL REQ. #:  H-0974.1 

Read first time 02/20/13.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to clinical review criteria used by insurers or utilization review entities; and adding a new section to chapter 48.43 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 48.43 RCW to read as follows:
     The clinical review criteria used by an insurer or a utilization review entity acting on its behalf shall: (1) Adhere to the federal food and drug administration prescription drug labeling; and (2) not require failure on the same American hospital formulary service medication class on more than one occasion for patients continuously enrolled in any plan offered by said insurer. Nothing in this section may be construed to prevent health care providers from prescribing a medication for an off-label use or from prescribing a medication on more than one occasion when they determine it is medically appropriate.