Senate Bill 1102 Summary

• Prohibits pharmacy benefit managers from limiting or excluding coverage of previously approved prescription drugs for covered individuals who remain enrolled in the same health plan, with coverage continuing through the end of the plan year.

• Requires pharmacy benefit managers and health care insurers to provide at least 60 days' written notice to affected individuals and prescribing providers before removing or changing coverage of any drug on the formulary.

• Establishes a formulary exception process requiring responses within 72 hours (or 24 hours for expedited reviews in exigent circumstances) and automatically approving exceptions for individuals renewing the same plan who have positive therapeutic outcomes on previously approved drugs.

• Mandates written denials of formulary exceptions include medical or pharmacological reasons and be made by a licensed pharmacist or medical director, with copies available for department inspection and subject to appeal rights.

• Applies to pharmacy benefit managers subject to Arizona's regulatory oversight and takes effect for contracts, policies, or coverage entered into, amended, extended, or renewed on or after December 31, 2025.