Fighting pharmacy denial of drug coverage

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pjbat
Regular Member


Date Joined Dec 2007
Total Posts : 119
   Posted 9/8/2009 2:56 PM (GMT -7)   
I am fighting Medco pharmacy as they have begun denying coverage for antibiotics as prescribed by my llmd. I am going through the appeal process but a friend of mine just forwarded a California law, AB 974 (pertaining to 'continuity of care'), which includes the following statements:
 
(3) Coverage for a drug shall not be limited or excluded for a
patient if the drug had previously been approved for coverage by the
plan for the patient as part of an ongoing drug therapy regimen.
   (b) For purposes of this section, "drug therapy regimen" shall
include a single medication or combination of medications, prescribed
by a person authorized to write a prescription pursuant to Section
4059 of the Business and Professions Code, to treat a medical
condition of a patient.
I'm wondering if anyone in California may have any experience with this. It seems like this is ammunition.
 
 
 

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