10 CRR-NY 69-10.13NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 10. DEPARTMENT OF HEALTH
CHAPTER II. ADMINISTRATIVE RULES AND REGULATIONS
SUBCHAPTER H. FAMILY HEALTH
PART 69. FAMILY HEALTH
SUBPART 69-10. NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.13
10 CRR-NY 69-10.13
69-10.13 Prior approval for treatment with a specialty drug.
A request for prior approval of treatment with a specialty drug must be accompanied by a written statement from the enrollee’s treating physician stating why treatment with the specialty drug is necessary, what other alternatives have been tried or explored, and what testing the enrollee has undergone for purposes of determining whether treatment with the specialty drug is appropriate and safe for the enrollee. All requests for prior approval for treatment with a specialty drug will be reviewed by the pharmacy benefits manager for the fund administrator and a determination will be made within three business days of receipt of all necessary information from the enrollee’s treating physician.
10 CRR-NY 69-10.13
Current through August 15, 2021
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