Title 20 — Insurance
29 chapters · 1,539 sections in this title.
A.R.S. § 20-3651 Definitions
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1. "Clinical practice guidelines" means a systematically developed statement to assist health care providers and patients in making decisions about appropriate health care for specific clinical circumstances and conditions. 2. "Clinical review criteria" means the written screenin…
A.R.S. § 20-3652 Applicability
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1. Any health care plan that is subject to state law regulating insurance, that provides prescription drug benefits and that includes coverage for a step therapy protocol regardless of how that coverage is described. 2. A contractor, agent or similar entity that implements covera…
A.R.S. § 20-3653 Clinical review criteria
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1. Recommend that the prescription drugs be taken in the specific sequence required by the step therapy protocol. 2. Except as provided in subsection B of this section, are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the…
A.R.S. § 20-3654 Exceptions; process
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B. A step therapy exception request shall be granted if sufficient justification and any necessary supporting clinical documentation are submitted to establish that any of the following applies: 1. The prescription drug required by the step therapy protocol is contraindicated or …