CA SB1052

Health care service plans and health insurers providing prescription drug benefits must post drug formularies on their websites, make them searchable by patients and providers, and update them monthly.

The Department of Managed Health Care and Department of Insurance must jointly develop a standard formulary template by January 1, 2017, which plans and insurers must use within six months of development.

The standard formulary template must include cost-sharing tiers, utilization controls (prior authorization or step therapy), preferred drug indicators, and educational information about drug coverage and non-formulary drug access.

The California Health Benefit Exchange must provide direct links to formularies for each qualified health plan offered through its website.

Amended Sections 1363.01 and 1368.016 of the Health and Safety Code and Section 10123.199 of the Insurance Code to reference the new formulary posting and display requirements.