Patients' Formulary Rights Act of 1999

Summary

Patients' Formulary Rights Act of 1999 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code to prohibit a group health plan, and the insurance issuer offering such coverage, from using a formulary (a plan which limits the particular drugs for which coverage will be available) unless the plan or issuer: (1) notifies participants, beneficiaries, and enrollees in advance about, and makes available to treating health care professionals under the plan, specified information concerning the formulary; (2) notifies such individuals of any changes in the formulary; and (3) when a drug is removed from the formulary, permits an individual to continue to have the drug prescribed for treatment of the same condition. Includes within required formulary information: (1) the extent of therapeutic substitution; (2) a complete list of all drugs included in the formulary; (3) information on access to nonformulary drugs; (4) whether or not, and to what extent, coverage will exist for nonformulary drugs; (5) copayments or other cost-sharing for formulary drugs; and (6) limits on coverage payments for outpatient formulary and nonformulary drugs. Amends title XVIII (Medicare) of the Social Security Act to require its authorized health insurance issuers and any Medicare+Choice organization to comply with such notification requirements in the same manner that such requirements apply to health insurance coverage or issuers in connection with a group plan. Requires the coordination of notification and formulary requirements through an interagency memorandum of understanding among the Secretaries of Labor, the Treasury, and Health and Human Services.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

No timeline events have been ingested for this record yet.

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 9 November 1999

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 9 November 1999

  ViewDownloadOpen at official source

• Introduced in House

  summary · EN · 9 November 1999

  Open at official source

Sponsors

No sponsors or actors listed by the source.

Related records

No cross-record relationships stored yet.