                                 CODE OF VIRGINIA

PRIOR AUTHORIZATION OF PRESCRIPTION DRUG PRODUCTS; COVERAGE UNDER STATE PLAN (§
32.1-331.15)

A. The Committee shall review prescription drug products to recommend prior
authorization under the state plan in accordance with this article and
regulations promulgated by the Board. Such review may be initiated by the
Director, the Committee itself, or by written request of the Board. The
Committee shall complete its recommendations to the Board within no more than
six months from receipt of any such request.

B. Coverage under the state plan for any drug requiring prior authorization
shall not be approved unless the prescriber obtains prior approval of such use
in accordance with regulations promulgated by the Board and procedures
established by the Department.
			In formulating its recommendations to the Board, the Committee shall consider
the potential impact on patient care and the potential fiscal impact of prior
authorization on pharmacy, prescriber, hospitalization and outpatient costs. Any
proposed regulation making a drug or category of drugs subject to prior
authorization shall be accompanied by a statement of the estimated impact of
such action on pharmacy, prescriber, hospitalization and outpatient costs.

C. The Committee shall not review any drug for which it has recommended or the
Board has required prior authorization within the previous 12 months, unless new
or previously unavailable relevant and objective information is presented.

D. Confidential proprietary information identified as such by a manufacturer or
supplier in writing in advance and furnished to the Committee or the Board
pursuant to this article shall not be subject to the disclosure requirements of
the Virginia Freedom of Information Act (&#xA7; 2.2-3700 et seq.). The Board
shall establish by regulation the means by which such confidential proprietary
information shall be protected.

HISTORY: 1993, c. 537; 2004, c. 855.