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Essential Health Benefits Prescription Drug Standard: The Exceptions Process
National Health Law Program [NHeLP]Link to more items from this source
May 8, 2015
"HHS revised the exceptions process for prescription drugs in order to establish a more uniform process across plans and issuers. HHS clarified that the exceptions process is different from the internal claims and appeals process for enrollees receiving an adverse benefit determination. While the adverse benefit determination process is for a drug that is included in the plan's formulary drug list, the exceptions process is for nonformulary drugs."

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