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Feds Outline What Insurers Must Cover, Down To Polyp Removal
Kaiser Health News Link to more items from this source
[Guidance Overview]
Feb. 21, 2013

"The final, 149-page rule retains requirements that insurers offer at least one drug per therapeutic category, or the same number as a state's benchmark plan, whichever is greater. Many state benchmark plans require at least two drugs per class. Responding to concerns from some advocacy groups, the final rule also states that insurers must have procedures to allow patients to get 'clinically appropriate' prescriptions not on the plan's list of covered medications."

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