MS SB2737

Requires insurers to provide a clear and expeditious process for prescribing practitioners to request overrides of step therapy or fail-first protocol restrictions on medications.

Mandates insurers grant override requests when practitioners demonstrate through sound clinical evidence that the required preferred treatment has been ineffective, is likely to be ineffective, or will cause adverse reactions based on the patient's characteristics.

Limits step therapy or fail-first protocols to a maximum of 30 days when treatment is deemed clinically ineffective, with possible extension up to 7 additional days if the practitioner shows the medication likely needs more time to provide relief.

Defines "insurer" to include health insurance policies, HMOs, PPOs, and group insurance plans, but excludes PPOs that function only as provider networks without defining health care benefits.

Takes effect January 1, 2012.