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State Laws

Search state statutes and regulations in all 50 states and the District of Columbia to find out what rights you have in your state and what other states are doing to empower physicians and patients in the face of health insurer market power.

To search for an exact phrase, you should enclose the entire phrase in quotation marks. For example, "patient care".
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State Law

Washington Admin Code-Title 284-Chapter 284-43-Subchapter D. Prior Authorization and Utilization Review

05/12/2025 Washington Sections 284-43-2021, 284-43-2022 and 284-43-5100

Prescription drug utilization management exception and substitution process; Time frame for exception and substitution request determinations; Formulary changes

Anti-retaliation, Step Therapy Override
State Law

Nebraska Rev. Statutes-Chapter 44. Insurance

12/19/2024 Nebraska Sections 44-7,112 through 44-7,117

Terms, defined; Health carrier or utilization review organization; step-therapy protocol, clinical review criteria; Step-therapy override exception, process; Step-therapy override exception, approval, procedure, effect; Rules and regulations; Act, applicability.

Step Therapy Override
State Law

Ariz. Rev. Statutes-Title 20. Insurance-Chapter 30-Article 1. General Provisions

07/28/2023 Arizona Sections 20-3651 through 20-3654

Definitions; Applicability; Clinical review criteria; Exceptions; process

 

Step Therapy Override
State Law

South Dakota Codified Laws-Title 58-Chapter. 17H. Utilization Review and Benefit Determinations

08/24/2023 South Dakota Section 58-17H-55

Step therapy override exceptions

Step Therapy Override
Ama Policy

Step Therapy H-320.937

08/30/2022

Step Therapy

Step Therapy Override
State Law

Texas Statutes-Insurance Code-Title 8-Subtitle E-Chapter 1369-Subchapter B. Coverage of Prescription Drugs Specified by Drug Formulary

08/05/2020 Texas Section 1369.0546

Step Therapy Protocol Exception Requests

Step Therapy Override
State Law

Maine Rev. Statutes-Title 24-A, Chapter 56-A, Subchapter 1. Health Plan Requirements

08/07/2023 Maine Section 4320-N

Step therapy

Medical Necessity-Definition, Step Therapy Override, U.R. Criteria
State Law

Illinois Compiled Statutes-215 ILCS 5/-Illinois Ins. Code-Article XX. Accident and Health Insurance

08/03/2023 Illinois Section 5/356z.29

Stage 4 advanced, metastatic cancer

Step Therapy Override
State Law

Wisconsin Statutes-Chapter 632-Subchapter VI. Disability Insurance

08/29/2023 Wisconsin Section 632.866

Step therapy protocols

Step Therapy Override, U.R. Criteria
State Law

Code of Virginia-Title 38.2-Chapter 34-Article 1. General Provisions

08/26/2023 Virginia Section 38.2-3407.9:05

Step Therapy Protocols

Step Therapy Override, U.R. Criteria